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.

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AI Agents That Deliver Better CX — Built on Trust

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Automated Resolution rate
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ROI on AI investment

Trust-Native Architecture

Built with trust, security and compliance engineered into the platform core–not layered on later.
Security & Compliance
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Governance

Built-in governance embeds guardrails, policy enforcement, and human oversight directly into AI execution.

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Observability

Maintain real-time visibility into agent behavior, reasoning, and performance.

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Auditability

Replay conversations end to end and generate regulator-ready records on demand.

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Data Protection

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.

Ushur Dashboard screen
Illustration showing ushur's omnichannel capability
Ushur Studio screen preview
Ushur Insights screen

Inbound and Outbound

Compliant, end-to-end customer engagement that proactively connects, resolves, and preserves context.

Omnichannel Continuity

Engage across SMS, email, voice, and web in one persistent, compliant interaction thread.

Built for Business Speed

A purpose-built orchestration environment designed for business users to bring journeys to life quickly.

Actionable Insights

Understand behavior, measure performance, and maintain audit-ready visibility with built-in compliance controls.

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

Company Type:
Health Payer
Provider
PBM
Pharmacy
LA&H
P&C
Consumer Lending
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Journey:
Acquisition
Retention
Member Service
Population Health & Quality
Claims & Administrative
Provider Service
Pre Visit
During Visit
Post Visit
Population Health & Quality
New Member Onboarding & Welcome
Member Service
Population Health & Quality
Mail Order Enrollment & Fulfillment
Claims and Administrative
New Member Onboarding & Welcome
Member Service
Population Health & Quality
Mail Order Enrollment & Fulfillment
Claims and Administrative
Group Quote Intake
Group Onboarding
Individual Acquisition
Member Service
Claims
Absence Management
Acquisition
Policyholder Service
Claims
Loan Originations
KYC and Onboarding
Loan Servicing
Loss Mitigation

Bill pay - payment capture

Bill delivery with safe and secure collection of payment information (credit, debit, ACH) to pass to payment processing

Care appointment reminders

Proactive care and provider appointment reminders with the ability to reschedule rather than no show (any provider type)

Enrollment in mail order program and Rx transfers

Education on benefits of mail order delivery and Rx transfer support

Profile Updates

Update Borrower information and contact preferences.

Workplace Accommodations

Educate the Member on available workplace acommodations, reduced hours, and reassignment programs available through their employer.

New patient welcome and information gathering

Patient education on provider and information and documentation completion

Endorsements and Riders

Guide the Policy Holder through amending, adding, and removing lines of coverage to their existing policy.

Vaccination outreach and scheduling

Education and appointment setting support for Vaccination with appointment reminders and reschedules

Vaccination reminders, education, appointment scheduling, and paperwork

Care education (preventative care)

Notifications to educate on the importance of adult and pediatric preventative care, related appointment setting

Policy Reinstatement

Guide the Policy Holder through re-instating a lapsed policy.

Post Disaster Outreach

Proactively reach out to Policy Holders after a Disaster, such as storm, wildfire, or flood to connect them to required services and relief, and to file any Claims if required.

Extraction (Basic Life)

Extract Basic Life related keys required for underwriting from structured Census files, semi-structured Prior Year Plans, and unstructured email body.

Annual Notice of Change (ANOC) FAQs

Proactive notifications and inquiry handling about Medicare Annual Notices of Change. Including FAQ support for top ANOC call drivers

Claim Status

Provide Member with the current status of a Claim.

Member after hours support

Accurate, secure and compliant AI Agent member inquiry and task completion support 24x7

Policy Cancellation

Guide the Policy Holder through cancelling their policy.

Surveys - Health Risk & Need Assessments, SDOH, Post Care / Rx Fill Experiences

Member surveys of health risks and needs, SDOH and post care experience and NPS surveys

Musculoskeletal (MSK) care management and navigation

Year-round support for members with Musculoskeletal conditions - including education, wellness, care gap closure, appointment setting

Grievance filing and updates

Ability for members to understand and file Grievances, and receive status updates

Retail-to-mail conversion

Support for education and retail-to-mail conversion

Digital consent

Ability for members to opt in to digital communications

Traditional app and portal registration support

Support for member app download and app and portal initial registration

Medication reconciliation

Education and scheduling of Medication Reconciliation appointments

Hardship Inquiry

Reach out to delinquent Borrowers with empathy to identify circumstances such as job loss, illness, divorce, deployment that may be eligible for relief measures.

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.

Supporting Documents

Remind and support Member in securely uploading required supporting documents for a Claim.

Prior authorization education and updates for transparency

Ability for patients to receive push notices for, or make inquiries about, prior authorization status

Medication adherence:

Understand root causes of medication non-adherence and overcome them

Chronic Condition care gap closure

Education, navigation support and appointment setting for any chronic condition care gap (diabetes, CKD...)

Adult Preventative Wellness

Ongong adult preventative wellness education, appointment setting and other actions

Appeal filing and updates

Ability for members to understand and file Appeals, and receive status updates

Appointment scheduling, reminders and rescheduling (any provider type)

Patient appointment setting support with reminders and ability to reschedule

Shipping status updates

Shipment status updates

Hospital discharge support

Support for inpatient to facility or home transitions to ensure safety and decrease readmissions

Member After hours Support

Accurate, secure and compliant AI Member inquiry and task completion support 24x7

Medication refills and reminders

Sharing of medication refills and reminders with ability to capture and overcome reasons for non adherence

New member welcome

New member welcome, overview of PBM supports and services, info gathering / sharing (including insurance ID card capture)

Policy Review (KYC)

Remind and support Member in securely uploading required supporting KYC documents during Policy Review.

First Notice of Loss

Guide the Claimant through the process of reporting the death of a Policy Holder and filing a Claim.

Email Triage

Automatically triage incoming servicing emails to identify intent and respond to service requests.

Claim status, adjudication and payment updates

Ability for providers to inquire about claim status, adjudication and payments

Traditional app and portal registration support

Support for member app download and app and portal initial registration

Appointment scheduling, reminders and rescheduling

Support for finding an in network provider and setting appointment via click-to-call or scheduling system integration

Medication adherence

Medication Adherence (overcome barriers - cost, transportation, adverse effects)

Pediatric Preventative Wellness

Ongoing pediatric preventative wellness education, appointment setting and other actions

Click-to-call or chat to speak to other clinical staff member

Click-to-call or chat to speak to other clinical staff member when needed

Supporting Documents

Remind and support Claimant in securely uploading required supporting documents for a Claim.

Retail-to-mail conversion

Support for education and retail-to-mail conversion

Update Beneficiaries

Update Beneficiaries and respond to major life events to ensure Policy Holder's benefits are paid to intended individuals.

Eligibility of Insurability (EOI)

Guide the new Member through a dynamic set of questions to determine their eligibiity for Insurance.

Plan Design

Triage inbound RFP emails to identify key attributes regarding Broker, Employer, Quote, and requested Products and automate case setup in Quoting and Underwriting systems.

Refill reminders and ordering facilitation

Refill reminders and ordering facilitation (including payment capture)

Schedule Appointment

Schedule follow up call with Sales Representative with reminders and rescheduling.

SDOH Resources (transportation, food)

Support for understanding and accessing SDOH resources such as nutrition, transportation

Extraction (Accidental Death & Dismemberment)

Extract Accidental Death and Dismemberment related keys required for underwriting from structured Census files, semi-structured Prior Year Plans, and unstructured email body.

Waitlisting

Proactive notifications of appointment availability for patients on wait lists

90-day fill conversion

Support for education and 90-day fill conversion

Eligibility and Out of Pocket Cost (OOP) verification

Ability for members to inquire about eligibility and verify out of pocket costs

Find a Primary Care doctor or Pediatrician

Support for finding a primary care doctor or pediatrician in network and setting appointment via click-to-call

Payment Status

Provide Borrower with the current status of a payment made to their account.

Experience and Net Promoter Score (NPS) surveys

Surveying capability for experiences and NPS scoring

Timely notifications to meet regulatory requirements

Ability to send notifications to members more timely to meet regulatory timing requirements

Trailing Documents

Remind and support Applicant in securely uploading required supporting documents post Application.

Provider after hours support

Accurate, secure and compliant AI Agent provider inquiry and task completion support 24x7

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.

Policy Review (KYC)

Remind and support Policy Holder in securely uploading required supporting KYC documents during Policy Review.

Brand-to-generic conversion

Support for education and brand to generic fill conversion

Support for shipping / delivery issues, returns and reshipment

Support for shipping / delivery issues, returns and reshipment

Community meeting invitations

Proactive invitations and RSVPs for community events and meetings (virtual and in person)

Chronic condition care navigation

Education, care management, navigation support and appointment setting for any chronic condition (diabetes, CKD...)

Proactive member out of pocket notifications

Proactive member out of pocket notifications – with support for “price shocks”

Vaccination reminders, education, appointment scheduling, and paperwork

Digital ID Card

Securely deliver a digital copy of Member's Insurance ID Card upon request.

Digital consent

Ability for members to opt in to digital communications

Patient questionnaire automation

Capture of patient information updates and support for review and e-signature for new patient paperwork

Member information updates

Member information updates – including cross-channel contact details and change of insurance

Diabetes care management and navigation

Year-round support for diabetic members including education, wellness, care gap closure, appointment setting

Member after hours support

Accurate, secure and compliant AI Agent member inquiry and task completion support 24x7

Preventative Wellness Care Gap Closure

Education, navigation support and appointment setting for any preventative wellness care gap (immunizations, cancer screenings)

Member contact information collection / updates

Collection of cross-channel member contact information to support better communications

Follow-up appointment scheduling

Patient appointment setting support with reminders and ability to reschedule

Shipping status updates

Shipment status updates

Click-to-call or chat to speak to pharmacy staff

Ability for pharma representatives to chat within Ushur journeys, and to warm call transfer to them

Patient after hours support

Accurate, secure and compliant AI Agent patient inquiry and task completion support 24x7

Claim Status

Provide Policy Holder with the current status of a Claim.

Product Comparison

Support Applicants in finding Insurance Plan options that best fit their needs.

Overview of PBM supports and services

Overview of PBM support and services and population health and quality programs

Care education (chronic condition management)

Notifications to educate on the importance of chronic condition management, related appointment setting

Click-to-call or chat to speak to pharmacy staff member

Click-to-call or chat to speak to pharmacy staff member when needed

Transition of care support

Support for inpatient to facility or home transitions to ensure safety and decrease readmissions

Support for shipping / delivery issues, returns and reshipment

Support for shipping / delivery issues, returns and reshipment

Benefit awareness and literacy

Support for member education on benefits and how to utilize them throughout the plan year

Confirmation of medication, immunization, DME orders / refills

Confirmation of medication, immunization, DME orders / refills

Employer Onboarding

Guide the Broker / Employer through the information required from them to onboard them into the Carrier's core systems.

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

Policyholder After hours Support

Accurate, secure and compliant AI Agent Policy Holder 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)

Surgery Confirmation

Collect detailed surgical information, including operative reports, discharge summaries, and post-operative recovery plans from the Claimant.

Click-to-call or chat to speak to other clinical staff member

Click-to-call or chat to speak to other clinical staff member when needed

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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.

Agentic AI that Analysts rave about

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