UTILIZATION MANAGEMENT
Simplify reviews.
Safeguard revenue.
Every missed or delayed status review puts patient care and your revenue at risk. Leveraging AltitudeAI™, Waystar’s Utilization Management (UM) software empowers your team to make quick, confident status decisions — allowing your team to strengthen compliance, tell a more complete patient story, and boost financial performance.
Prioritize reviews + protect reimbursement
High case volumes and shifting payer rules can let critical reviews slip through the cracks, leading to denials, underpayment, and records that don’t reflect the appropriate level of care. Waystar’s UM solution scans patient records in real-time and flags high-priority cases, delivering actionable insights for faster decisions and fewer delays.
See it in action
CLINICAL INTELLIGENCE + FINANCIAL INSIGHTS
Review the right cases, faster
Stop letting manual and inefficient case reviews slow you down. Waystar’s Utilization Management software uses AI and advanced automation to keep reviews moving forward — summarizing key chart information, surfacing status issues, and satisfying payer requirements for more timely decisions and stronger reimbursement.
“Within two hours of ED presentation, we have a reliable prediction of inpatient vs. observation — helping both our UM and ED teams prioritize quickly. It’s fast, consistent, and puts everything our staff needs right at their fingertips.”
—Linda Supplee, Chief Population Health Officer, Genesis HealthCare System
By The Numbers
<4mins
for first-level review time²
63%
greater productivity efficiency¹
<2%
Obs-to-IP conversion medical necessity denial rate¹
12.3K+hrs
avg. annual time saved per client through faster first-level reviews¹
$4.9M
revenue gained from timely observation-to-inpatient conversions²
¹ Waystar annual cohort analysis
² Success story, Genesis HealthCare System, 2025
Trending resources
Clinical Integrity + Revenue Capture
Genesis HealthCare’s way forward
Request a demo for Waystar Utilization Management
See our AI-powered UM software in action. Reach out to a Waystar expert today for a personalized product tour.