Intelligent AI-enabled
utilization management

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.

Real-time insights to support determinations

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.

Reduce manual chart review

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.

Scale clinical expertise

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.

Improve peer-to-peer readiness

Real-time, point-of-care guidance aligns documentation to payer and compliance expectations. That means fewer denials, fewer headaches, and more time for patients.

Seamless process integration

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.

Reduce cognitive burden

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.

10K+

diagnoses and procedures captured by proprietary clinical AI algorithms

Up to

40%

time saved for utilization review nurses

31%

reduction in cognitive burden

43K+

reviews of AI-generated summaries by board-certified physicians

Making waves with SmarterUtilization

HOW IT WORKS

1

Automate first 24-hour assessment

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.

2

Generate detailed summaries

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.

3

Improve care coordination

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.

4

Simplify
discharge planning

Inline suggestions helps ensure accuracy, completeness, compliance, and appropriate reimbursement.

Smarter,

safer AI

AI safety is more than a principle at SmarterDx: Our commitment to AI safety is core to everything we do at SmarterDx. Guided by our Clinical AI Safety Institute, we combine human and machine oversight to ensure every recommendation is accurate, reliable, and clinically meaningful. From how our models generate text and predictions, to minimizing hallucination risks, to ensuring models align with provider preferences; we put rigorous guardrails in place so providers can trust the insights they receive.

We pair this disciplined development approach with strict compliance to HIPAA, security best practices, and all relevant regulations to protect the privacy, trust, and reputations of our health system partners.

Safe AI isn’t just about what we build; it’s about how we stand behind it. With rigorous testing, human-in-the-loop oversight, and a dedication to adapting as new research emerges, SmarterDx is setting the bar for what trustworthy clinical AI should look like.

Contact Us

Let’s get differentially better

Ready to learn more? Get in touch with us today and we’ll set you on the path to revenue integrity.