The AI Agent-powered CX platform for regulated industries
Purpose-built for regulated industries, delivering proactive outbound and inbound engagement — with compliance and auditability embedded into every interaction.
AI Agents That Deliver Better CX — Built on Trust
Trust-Native Architecture
Built-in governance embeds guardrails, policy enforcement, and human oversight directly into AI execution.
Maintain real-time visibility into agent behavior, reasoning, and performance.
Replay conversations end to end and generate regulator-ready records on demand.
Safeguard PHI, PII, and financial data with policy-aware segmentation and governed access.
The Ushur Agentic Platform
Enterprise AI Agents
AI agents that plan, reason, retrieve data, validate inputs, and resolve complex customer requests end-to-end — with built-in governance, human-in-the-loop safeguards, and full audit visibility.
One Platform. Endless Possibilities
A curated suite of Customer Experience Automation use cases built for regulated enterprises. Secure, compliant, and designed to resolve customer needs from start to finish
Prior Authorization transparency support
Ability for members to receive push notices for, or make inquiries about, prior authorization status
Community meeting invitations
Proactive invitations and RSVPs for community events and meetings (virtual and in person)
Member ID card and driver's license digital collection
Safe and secure collection of member ID card(s), driver's license images
Benefits Education
Answer Member questions on Plan benefits, coverage, and eligibility.
Find a Provider
Patient support in finding in network doctors (of any type) that best fit their needs
Member after hours support
Accurate, secure and compliant AI Agent member inquiry and task completion support 24x7
Census Transformation
Identify Census files in an inbound RFP and Transform the file to the standard format required by the Carrier and identify any issues.
Vaccination reminders, education, appointment scheduling, and paperwork
Notification of shipment with tracking number and delivery instructions
Notification of shipment with tracking number and delivery instructions (i.e. someone needs to be home at delivery)
Policy Cancellation
Guide the Policy Holder through cancelling their policy.
Overview of pharmacy supports and services
Overview of pharmacy support and services and population health and quality programs
Overview of PBM supports and services
Overview of PBM support and services and population health and quality programs
Supporting Documents
Remind and support Claimant in securely uploading required supporting documents for a Claim.
Traditional app and portal registration support
Support for member app download and app and portal initial registration
Incontinence education and support
Education and connectivity to support resources for incontenence
Support for shipping / delivery issues, returns and reshipment
Support for shipping / delivery issues, returns and reshipment
Payment Status
Provide Member with the current status of a payment on a Claim.
Redetermination journey support (Medicaid)
Support for member retention with ongoing redetermination process education, support and services - until redetermination is complete
Follow-up appointment scheduling
Patient appointment setting support with reminders and ability to reschedule
Medication reconciliation
Education and scheduling of Medication Reconciliation appointments
Respiratory Care care management and navigation (COPD, Asthma)
Year-round support for members with Respiratory Disease - including education, wellness, care gap closure, appointment setting
Appointment reminder and rescheduling
Member appointment reminders for care management, provider appointments (any type), home health visits and more
First Notice of Loss
Guide the Claimant through the process of reporting the death of a Policy Holder and filing a Claim.
Sales appointment setting and reminders
Member appointment setting with service or sales agents in support of their buying process
Extraction (Hospital Indemnity)
Extract Hospital Indemnity related keys required for underwriting from structured Census files, semi-structured Prior Year Plans, and unstructured email body.
Ongoing website, portal, & app adoption and utilization
Support for member ongoing utilization of website, traditional apps and portals
Patient after hours support
Accurate, secure and compliant AI Agent patient inquiry and task completion support 24x7
ER avoidance
Education on when to use sites of care that are alternatives to the ER (telehealth, urgent care)
Medication adherence:
Understand root causes of medication non-adherence and overcome them
Click-to-call or chat to speak to pharmacy staff member
Click-to-call or chat to speak to pharmacy staff member when needed
Adult Preventative Wellness
Ongong adult preventative wellness education, appointment setting and other actions
Cost transparency and cost relief
Education on cost tranparency and cost relief options
Annual Wellness Visit (AWV) outreach and scheduling
Education and appointment setting support for Annual Wellness Visits (AWV) with appointment reminders and reschedules
Digital consent
Ability for members to opt in to digital communications
Live clinical chats and warm call transfers
Ability for clinical representatives to chat within Ushur journeys, and to warm call transfer to them (RN, Pharma, Care Manager)
SCRA Protection
Securely collect proof of Active Duty Servicemembers in order to trigger financial protections.
Product Comparison
Support for Applicants to find Lending options that best fits their needs.
Endorsements and Riders
Guide the Policy Holder through amending, adding, and removing lines of coverage to their existing policy.
Pediatric preventative wellness
Ongoing pediatric preventative wellness education, appointment setting and other actions
Pre visit preparation instructions
Sharing of pre visit preparation instructions with ability to automate answers to inquiries
Claim Status
Provide Policy Holder with the current status of a Claim.
Proactive member out of pocket notifications
Proactive member out of pocket notifications – with support for “price shocks”
Site of care guidance (wayfinding)
Support for appropriate site of care with appointment setting
Payoff Request
Guide Borrower through requesting an official Payoff Letter for their loan.
Claim Status
Provide Member with the current status of a Claim.
Care Management connectivity
Notifications to educate on the importance of Care Management and set appointments
Medication refills and reminders
Sharing of medication refills and reminders with ability to capture and overcome reasons for non adherence
Member information updates
Member information updates – including cross-channel contact details and change of insurance
Surgery Confirmation
Collect detailed surgical information, including operative reports, discharge summaries, and post-operative recovery plans from the Claimant.
Retail-to-mail conversion
Support for education and retail-to-mail conversion
Medication adherence
Understand root causes of medication non-adherence and overcome them
Claim status, adjudication and payment updates
Ability for providers to inquire about claim status, adjudication and payments
Click-to-call or chat to speak to pharmacy staff member
Click-to-call or chat to speak to pharmacy staff member when needed
Extraction (Short Term Disability)
Extract Short Term Disability related keys required for underwriting from structured Census files, semi-structured Prior Year Plans, and unstructured email body.
Census Upload
Guide the Broker / Employer through uploading an updating Census file, Transforming it to the standard format required by the Carrier, and identifying any issues.
Adult preventative wellness
Ongong adult preventative wellness education, appointment setting and other actions
Cost transparency (Good Faith Estimate)
Providing out of pocket cost transparency via Good Faith Estimates
Paperless Statements
Ability for Borrowers to opt in to digital delivery of Statements.
Health Risk Assessment HRA surveys
Full Health Risk / Needs Survey completion with feeds to core systems for follow-up
Escrow Review
Guide Borrower through shortfalls or excesses in their escrow account, the tax or insurance payments that led to the shortfall, and to securely accept payments for any shortfall.
Bill pay - payment capture
Bill delivery with safe and secure collection of payment information (credit, debit, ACH) to pass to payment processing
Update Beneficiaries
Update Beneficiaries and respond to major life events to ensure Member's benefits are paid to intended individuals.
Enrollment in mail order program and Rx transfers
Education on benefits of mail order delivery and Rx transfer support
Digital ID Card
Securely deliver a digital copy of Policy Holder's Insurance ID Card upon request.
Waitlisting
Proactive notifications of appointment availability for patients on wait lists
Clinical guideline requests and inquiries
Ability for providers to request clinical guidelines
Digital Consent
Ability for Members to opt in to digital communications.
Appointment scheduling, reminders and rescheduling (any provider type)
Patient appointment setting support with reminders and ability to reschedule
Extraction (Dental)
Extract Dental related keys required for underwriting from structured Census files, semi-structured Prior Year Plans, and unstructured email body.
Member information updates
Member information updates – including cross-channel contact details and change of insurance
Transition of care support
Support for inpatient to facility or home transitions to ensure safety and decrease readmissions
Retail-to-mail conversion
Support for education and retail-to-mail conversion
Preventative wellness
Education and appointment setting for preventative wellness medications, immunizations and tests
Medication reconciliation
Education and scheduling of Medication Reconciliation appointments
Timely notifications to meet regulatory requirements
Ability to send notifications to members more timely to meet regulatory timing requirements
Extraction (Voluntary Life)
Extract Voluntary Life related keys required for underwriting from structured Census files, semi-structured Prior Year Plans, and unstructured email body.
Click-to-call or chat to speak to sales representative
Ability for service or sales representatives to chat within Ushur journeys, and to warm call transfer to them
Policy Review (KYC)
Remind and support Member in securely uploading required supporting KYC documents during Policy Review.
Refill reminders and ordering facilitation
Refill reminders and ordering facilitation (including payment capture)
Eligibility and Out of Pocket Cost (OOP) verification
Ability for members to inquire about eligibility and verify out of pocket costs
Provider roster directory updates
Ability for any provider to update their roster information for provider directory accuracy
Cancer Screening outreach and scheduling
Education and appointment setting support for Cancer Screening with appointment reminders and reschedules
Digital consent
Ability for members to opt in to digital communications
Proactive Rx status notifications
Proactive Rx status notifications (fill status, issues like prior auth)
Follow-up appointment scheduling
Patient appointment setting support with reminders and ability to reschedule
Care plan adherence
Notifications to educate on the importance of care plan adherence, related appointment setting
Prior authorization education and updates for transparency
Ability for patients to receive push notices for, or make inquiries about, prior authorization status
Disaster Preparedness
Proactively reach out to Policy Holders prior to a disaster, such as storm, wildfire, or flood and educate them on preparedness.
KYC Supporting Documents
Remind and support borrower in securely uploading required supporting KYC documents during Onboarding.
Social Determinant of Health SDOH surveys
Social Determinant of Health SDOH survey completion with feeds to core systems for follow-up
ER avoidance
Education on when to use sites of care that are alternatives to the ER (telehealth, urgent care)
Co-payment collection
Safe and secure collection of payment information (credit, debit, ACH) to pass to payment processing
Shipping status updates
Shipment status updates
Pediatric Preventative Wellness
Ongoing pediatric preventative wellness education, appointment setting and other actions
Profile Updates
Update Borrower information and contact preferences.
Provider search and selection support (any provider)
Support member ability to search for any type of in network provider and click-to-call to set appointments
Chronic Condition care gap closure
Education, navigation support and appointment setting for any chronic condition care gap (diabetes, CKD...)
Notification of shipment with tracking number and delivery instructions
Notification of shipment with tracking number and delivery instructions (i.e. someone needs to be home at delivery)
Diabetes care management and navigation
Year-round support for diabetic members including education, wellness, care gap closure, appointment setting
Member contact information collection / updates
Collection of cross-channel member contact information to support better communications
Don’t see the use case you are looking for? Let’s talk about your unique requirements. Schedule time with our team to explore what is possible.
