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AI Solutions for Utilization Review

Apply artificial intelligence to power your utilization review (UR) process.


Explore our AI-powered UR solutions

Optum offers physician advisor expertise, evidence-based medical research and sophisticated artificial intelligence (AI) technology to support appropriate reimbursement and accurate documentation.

We team up with your physicians to pinpoint improvement opportunities. Our solutions combine AI-powered technology and proven clinical services to provide our client hospitals with a comprehensive utilization review program tailored to address your unique needs, both now and in the future. Choose from services, technology or a combination of both to fit your needs.

Why use AI utilization review services

Whether using our clinicians or empowering your own, our UR solutions focus clinician attention on the cases that need it most, letting you redeploy your clinicians to other patient-focused responsibilities. Our services alleviate staffing challenges by augmenting your teams with our broad, global talent pool.

Raising revenue integrity with AI-powered technology

Our on-site and remote UR services can apply AI to drive timely patient-status determinations. Citations to our unmatched foundation of evidence-based medical research strengthen our patient status arguments, while our artificial intelligence enables a more thorough review of cases. By raising defensibility against denial and audit, we strengthen your revenue integrity and improve compliance

How .artificial intelligence technology can streamline utilization review

We deliver greater efficiency, accuracy and integrity to your utilization review process and outcomes. We can help you reduce denial rates, improve appropriate reimbursement and minimize audit risk. And our technology can help your internally sourced physician advisors become more effective and efficient.

Learn how AI can help improve your utilization review process