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 utilization management (UM) teams move faster.
The sheer amount of data and decisions that need to be made in a short amount of time mean manual utilization reviews and level of care determinations can create costly bottlenecks. Other AI solutions merely prioritize cases or can’t provide the supporting context to make justifiable decisions.
SmarterUtilization surfaces real-time clinical evidence to support utilization review and level of care determinations that justify medical necessity and care coordination. Get all of the evidence and justification your team needs to make fast, clear, informed decisions.
How it works
Give your teams time back 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 details with clinical guidelines to scale the expertise needed for defensible level of care decisions — while your team stays in full control to verify the details.
Real-time diagnosis recommendations align documentation to payer and compliance expectations. Fewer denials, fewer headaches, more time for patients.
SmarterUtilization embeds UM summaries, inpatient criteria, and status indicators directly into existing EHR workflows, so reviewers find what they need without chasing details across the chart.
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.
Our Clinical AI platform
We employ a robust human-in-the-loop system to ensure AI-generated content is accurate. 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.
Every recommendation cites the specific labs, notes, orders, and vitals that support it — no unsupported claims.
Clinical AI surfaces; your clinicians decide. Nothing is finalized without your team’s review and approval.
Models are trained and evaluated on 21M+ clinically validated encounters, not open-web text.
Findings are monitored against clinical guidelines and audited for accuracy on an ongoing basis.
Contact us
If you're ready for clinical AI that surfaces the most relevant clinical evidence to support medical necessity and level of care decisions… you're in the right place. Let's chat about helping your health system.
