Ushur, a leader in AI-powered Customer Experience Automation for regulated industries, has introduced its Agentic AI solution designed specifically for health plans’ provider relations, network management, and contact center teams. The new AI agent enables human-like, conversational self-service through voice and chat to address the most frequent and costly provider inquiries, aiming to reduce administrative burden, improve compliance, and bolster provider satisfaction.
Provider delays in obtaining information from health plans often ripple to patients and members. Ushur’s AI Agent addresses this problem by integrating with benefits, claims, and credentialing systems to deliver a HIPAA-secure, omnichannel experience that guides providers through key processes:
- Benefits Verification – Provides real-time, contract-specific answers to pre-treatment coverage questions, reducing denials and billing disputes.
- Claims Inquiry & Documentation – Automates claim status checks, requests, and ingestion of missing documentation to accelerate adjudication.
- Credentialing & Network Management – Streamlines provider onboarding and directory updates, reducing onboarding timelines and audit exposure.
Ushur’s domain-specific LLMs are trained on healthcare payer language and processes. When deployed as AI Agents, they integrate with core systems to automate provider interactions with precision and compliance.
“Health plans and providers deserve a better way to connect — one that replaces administrative friction with clarity, speed, and trust,” said Simha Sadasiva, CEO and Co-Founder of Ushur. “With our Agentic AI for provider servicing, we’re reimagining how these relationships work — delivering secure, compliant, and human-like experiences that scale. When providers are supported more efficiently, patients gain faster access to care. This is the next evolution in making healthcare smarter, faster, and more connected.”
Ushur’s AI Agent for Provider Service enables health plans to deliver consistent, human-like support around the clock, scaling personalized interactions across the entire provider network. Ushur also offers AI Agents for Member Service to eliminate member-facing bottlenecks and elevate service quality across the healthcare ecosystem.
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