Optyzone

Medical Bill Review Agent

Reviews medical bills on injury claims for repricing, fraud signals, and treatment appropriateness.

WCMedical
Medical Bill Review Agent
Polished agent demo — preview
Agent running
Agent thinking
  1. 1Reading inputs and pulling relevant context across systems…
  2. 2Building a plan: 4 steps, 2 tools, 1 human approval gate.
  3. 3Executing steps with progress streaming back to the user.
  4. 4Decision made. Drafting summary and queuing for review.
This demo is a polished preview. Book a build to see the production version.

The problem

Medical bill review is manual and inconsistent. Overpayments and missed adjustments compound.

What the agent does

  • Reprices bills against fee schedules and PPO contracts
  • Detects coding anomalies and treatment inconsistencies
  • Generates EOR with explanation for the provider

Business value

Recovers 8–14% more on medical spend and shortens review cycle time.

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