Cohere Health introduced a new tool for payers called Review Assist. It is meant to support health plan clinical staff with prior authorization reviews and other use cases.
Cohere Health, a clinical intelligence company, launched a new solution called Review Assist, which speeds up medical necessity reviews for health plans, the company announced on Monday.
Boston-based Cohere Health provides AI-powered prior authorization solutions to help improve the relationship between payers and providers. The new tool is meant to help health plan clinical staff with prior authorization reviews, which are often extremely burdensome, according to the company. The typical process requires reviewers to analyze hundreds of pages of clinical records in order to determine if a patient procedure is medically necessary.
Review Assist operates within existing utilization management workflows. It uses Cohere’s AI and large language models to analyze unstructured and structured clinical data and provide actionable insights for reviewers, as well as links to its source for this information. In addition, it has an AI chatbot that can answer questions for the reviewer and find additional insights.
Along with prior authorization requests, the product can also be used for appeals, HEDIS measures and other use cases.
“What we’ve built is essentially a co-pilot. … It is installed on top of and over your existing applications and it really works to focus and support the users of those applications, who are really clinical users — nurses, MDs — who are evaluating complex clinical questions,” said Matt Parker, chief product officer at Cohere Health, during a recent interview at the AHIP 2025 conference in Las Vegas.
He added that Review Assist can help payers ensure patients receive the right care at the right time.
“You don’t want to delay care,” Parker said. “You want to make sure care is done appropriately [and that] it’s done on time and it’s done correctly. And so providing opportunities to improve the speed and accuracy of this information, we think is really important.”
Review Assist has already shown some positive results. According to data from Cohere Health, it can improve medical necessity review efficiency by up to 50% with over 99% precision. To further measure the effectiveness of the product, Cohere Health will track accuracy, efficiency and compliance, Parker said.
Share:
About the Author: Cohere Health
