Powered by the Dragonfly™ platform, Utilize gives clinical teams a complete view of every patient to confidently support medical necessity and ensure the right care at the right time.
By streamlining utilization review, case management, and revenue cycle tasks into one platform, Utilize reduces manual work, speeds up decision-making, and helps teams stay focused on what matters most-delivering appropriate, efficient care.
Bidirectional (inbound and outbound) integration capabilities allow information to flow automatically to and from your EMR for streamlined workflows and fully integrated data.
See the full patient picture in real time, prioritized by risk. Smart automation reduces manual work, streamlining workflows for clinical teams.
Create alignment between clinical and financial teams to improve patient status accuracy from bedside to final payment. Prevent unnecessary medical necessity denials, reduce costly retrospective audits and lower the overall cost of care.
Utilize aligns utilization review and revenue cycle teams with their payer partners to standardize, automate, and streamline processes-reducing friction and ensuring that patients are in the right status, at the right time, with the right reimbursement.
Reduce Manual Work by Automating Tasks
Dragonfly Utilize enables teams to zero in on the cases that need their attention so no time is wasted manually reviewing, driving clinical efficiencies. Dragonfly Utilize’s AI-driven medical necessity score, the Care Level Score™ (CLS™), continuously pulls real-time data from the EMR to identify and prioritize patients as their encounters evolve and predict medical necessity with 94% accuracy.
Dragonfly’s Generative AI pulls key information into clinical summaries within the Patient Detail page reducing the time to complete medical necessity reviews by more than half and improving documentation.
Ensure Correct Payment and Compliance
Using an objective, data-driven view of medical necessity focused on “getting it right”, Utilize helps your organization capture the right revenue for the care provided by improving patient status accuracy, optimizing observation rates and correctly identifying Inpatient Only procedures.
Your teams can mitigate unnecessary denials and resolve denials that do occur faster with AI-driven insights, smarter downgrades and predictive appeal support-including automated clinical summaries for medical necessity appeal letters, delivered directly within the workflow.
Drive Performance, Reduce Risk and Maximize ROI
Make confident decisions with powerful, data-driven insights at your fingertips. Utilize Performance Insights helps you uncover opportunities for improvement, monitor key trends, and proactively address risks before they become disruptions.
With robust reporting on key KPIs and product adoption, you can clearly measure impact and continuously enhance value over time, ensuring you’re getting the most from your investment.
Utilize now includes powerful Generative AI capabilities that streamline the utilization review (UR) process, helping clinicians spend less time on documentation and more time on patient care. AI-guided initial reviews generate concise, comprehensive summaries directly within the UR workflow, saving nurses an average of 15 minutes per case. With our Human-in-the-Loop approach, UR nurses can easily review, refine, and finalize summaries ensuring accuracy, while accelerating approvals and reducing denials. The result is greater efficiency, improved coordination, and tools that truly make a difference in day-to-day clinical practice.
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"The Xsolis platform and the CLS enable our nurses to focus on cases requiring their clinical expertise, while automating cases that don't need an in-depth review. This allows our nurses to practice at the top of their license and apply their valuable clinical knowledge more effectively."
Pamela Foster, MBA, MSW
Vice President of Care CoordinationHonorHealth
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Utilization management software enables real-time assessment of patient care across settings to ensure clinical appropriateness and cost efficiency. It replaces manual reviews with streamlined workflows, enabling teams to make faster, consistent decisions that support both patient outcomes and financial integrity.
Utilization management automation applies algorithms and decision logic to flag and route cases, reduce manual reviews, and generate clinical summaries. This automation saves time, lowers operational burden, and allows staff to focus on the highest value cases.
A strong healthcare utilization management software should support prospective, concurrent, and retrospective review, integrate with clinical and financial systems, offer audit support, and deliver analytics that help monitor trends and performance across utilization.
You want a solution that integrates with your EMR, offers configurable workflows, and supports intelligent automation. The best utilization management software also delivers robust reporting, ease of use, and scalability, so it evolves with your needs.
AI utilization management uses machine learning and natural language processing to predict medical necessity, surface key clinical information, and support appeals. It accelerates utilization review and boosts accuracy while leaving final decision control in human hands.
A utilization review software system is specifically focused on the assessment process, or reviewing the clinical necessity of services. Utilization management software is broader: it encompasses review, workflow orchestration, integration, reporting, and decision support across the continuum.