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SmarterUtilization™ is advanced clinical AI that surfaces the most relevant clinical evidence to support medical necessity and level of care decisions made by your care team. That means reduced denials, shorter review times, and faster reimbursement. No more bottlenecks. Just evidence-backed decisions that help UM teams move faster.
Make UM lightning-fast. Power defensible UM decisions.
Your team deserves real-time insights. And our advanced clinical AI delivers...and then some. SmarterUtilization surfaces clinical evidence to support utilization review and level of care determinations that justify medical necessity and care coordination from admission to discharge.
Give your teams time back, sharpen every determination, and quickly understand each patient’s condition, history, and level of care needs. SmarterUtilization helps UM teams stop hunting for evidence and move at the speed today’s hospitals require.
Automatically match patient health details with clinical guidelines to scale expertise needed to translate patient care for defensible level of care decisions. Plus, your team stays in full control to verify the details.
Real-time, point-of-care guidance aligns documentation to payer and compliance expectations. That means fewer denials, fewer headaches, and more time for patients.
Put the answer where your team already works. SmarterUtilization embeds UM summaries, inpatient criteria, and status indicators directly into existing EHR workflows, so reviewers can find what they need without chasing details across the chart.
Catch the clinical details that change the decision. Simplify review of the patient’s course, treatment, and condition to help teams support timely authorizations and smoother care transitions by aligning UR processes with physician documentation.
diagnoses and procedures captured by proprietary clinical AI algorithms
Up to
time saved for utilization review nurses
reduction in cognitive burden
reviews of AI-generated summaries by board-certified physicians
Surface a complete clinical picture upfront — including key trends and findings from the patient chart.
Use clinical AI to confidently route patients to the right level of care based on severity of illness and intensity of treatment.
Empower UR nurses with automated summaries that deliver a comprehensive view of a patient’s hospital course, treatment, and services provided.
Understand medical necessity insights to simplify peer-to-peer alignment with physician advisors for escalated cases.
Support care handoffs and transitions by embedding clinical AI into the utilization management process to support level of care determinations with clinically defensible medical necessity insights.
Inline suggestions helps ensure accuracy, completeness, compliance, and appropriate reimbursement.
SafeRead Verification Process
1
Generate
AI creates initial clinical summary
2
Detect
Adversarial models flag risks
3
Escalate
Flagged items sent for review
4
Evaluate
Physicians review in SafeRead
5
Verify
Approved content sent to EHR
6
Validate
Feedback enables AI improvement
We employ a robust human-in-the-loop system to enhance the accuracy of AI-generated content. Our proprietary framework categorizes AI errors by severity, while our patented SafeRead platform combines adversarial AI models with board-certified physician oversight to monitor for bias, hallucinations, and omissions — with continuous feedback enabling ongoing improvement.
Ready to learn more? Get in touch with us today and we’ll set you on the path to revenue integrity.
