Smart UM Suite

ZeOmega’s AI-Agent Powered Utilization Management Solutions

Smart UM is a modular, Agentic AI-powered Utilization Management (UM) suite designed to automate and orchestrate the entire prior authorization and medical necessity review lifecycle. Built on responsible AI principles and reinforced with strong human-in-the-loop controls, Smart UM enables intelligent agents to perceive, reason, act, and learn — while accelerating decisions, reducing administrative burden, and improving outcomes for payers, providers, and members.  

The suite brings together FHIR^®-enabled semantic interoperability, agentic AI intake and orchestration, predictive decisioning agents, medical policy digitization agents, and AI-assisted clinical review agents into a unified yet independently deployable ecosystem. Each module can operate as standalone solutions and collaboratively across the suite to deliver compounding value across utilization management operations.

Smart UM is platform-agnostic, enables scalable provider connections, and aligned with regulatory and turnaround-time requirements — enabling organizations to evolve from manual, reactive utilization management processes to intelligent, self-optimizing, and transparent utilization management workflows.