Cohere Health®, a leader in clinical intelligence solutions, has introduced Review Assist, an agentic AI breakthrough engineered to revolutionize medical necessity reviews for health plans and risk-bearing providers. The platform accelerates review efficiency by up to 50% while delivering over 99% precision, seamlessly integrating into existing utilization management workflows. By rapidly pinpointing critical clinical information, Review Assist significantly reduces review times, alleviates administrative burdens, and empowers nurse reviewers to make faster, more accurate decisions.

Despite meaningful advancements in healthcare technology, prior authorization reviews remain a painstaking, manual task, often requiring reviewers to comb through extensive clinical records to extract the crucial data needed for assessing medical necessity. However, a wave of optimism is emerging in the field. Building on its proven Review solution, Cohere Health introduces Review Assist—an AI-driven tool designed to dramatically boost clinical productivity and enhance the nurse reviewer experience. This versatile technology not only streamlines the review process but also adapts seamlessly to any situation involving complex medical record analysis, heralding a new era of efficiency and clarity in healthcare.

"While existing automation tools attempt to assist reviewers, they are often limited in their ability to identify, surface, and cite data from unstructured clinical documentation, particularly in high-volume, high-cost, and complex areas," said Matt Parker, chief product officer at Cohere Health. "The Review Assist copilot experience is a significant advancement in how health plans can address challenges in getting patients to care. This intelligent assistant enables faster, clinically sound decisions without disrupting existing workflows, and demonstrates the foundation for how we'll apply this agentic technology to challenge the status quo."

Review Assist leverages Cohere's clinically trained AI and fine-tuned large language models (LLMs) to analyze unstructured and structured clinical data in real time, surface relevant evidence, and present clear, actionable insights for reviewers. By providing this added layer of clinical intelligence, Review Assist enhances review accuracy and consistency, and improves nurse productivity and experience.

With an intuitive, lightweight design that works on top of a health plan's technology, Review Assist is quick to implement and easy to adopt, ultimately helping health plans drive operational efficiencies and faster access to appropriate member care–without adding complexity to or changing nurses' workflows. This agentic AI technology can enable other health plan clinical intelligence workflows downstream from prior authorization approvals.

Key capabilities and benefits of Review Assist include:

• Operates directly within existing UM workflows or can be integrated into any client case system
• Real-time extraction and citation of indication data and source evidence via clinically trained AI
• Reduced review time, error rates, and administrative burden for nursing staff
• Faster access to medically necessary care for members

Review Assist is now available for health plans. Discover additional details at coherehealth.com/review-assist.