Help your nurses make faster, more accurate clinical decisions within your existing UM system.
Review Assist leverages clinical-grade AI to reduce medical necessity review burden and streamline the work of review nurses by quickly surfacing indication data right in existing utilization management solutions (previously buried in lengthy documents).
Reduce review times by 35% with AI-powered clinical insights. Give reviewers automated, clinically-appropriate information to streamline the manual review experience.
Drive reviewers to the appropriate guideline and uncover clinical indications with greater precision than off-the-shelf LLMs. Facilitate more accurate and complete medical necessity reviews with better decision quality.
Built on top of existing health plan systems and workflows, Review Assist requires minimal changes. Reviews gain access via a simple interface that overlays your existing UM system.
Unlock the capability to go from automated recommendations to touchless, clinically-appropriate auto-approvals for up to 25% of the most clinically complex reviews of unplanned conditions, with greater than 99% precision.
A comprehensive clinical decision support solution designed to work seamlessly with your existing workflow.
Automatically summarizes foundational case information for quick case orientation and faster decision-making.
Smart AI suggestions of the likely primary condition(s) based on clinical context to guide appropriate guideline selection.
Surfaces condition-specific insights and patient indication data with direct links to source evidence within clinical documentation.
Easy navigation interface for source evidence, making it simple to review and verify clinical information.
Powerful AI-based chat experience that helps reviewers identify additional clinical insights and answer specific questions.
Seamlessly integrates with existing UM systems - reviewers copy insights back to their system of record with familiar workflows.
Estimated Impact
Real results for health plans and their teams.
35%
faster AI-assisted reviews
10%
fewer unnecessary complex case reviews
1+ days
faster TAT on standard reviews
Reduce administrative burden and improve clinical decision quality for your most complex use cases. Special discount available for the next 6 months.
Review answers to FAQs
Unlike other widely available solutions, Cohere’s fine-tuned AI models have been trained by a team combining technical and clinical expertise to accurately cite clinical indication data buried in hundreds of pages of attachments, quickly surfacing indications to inform reviewers and accelerate decision-making.
No, health plans can leverage Review Assist as a standalone, lightweight solution that intuitively works on top of existing UM solutions to provide an additional layer of advanced clinical insight.
No, there are no special intake channel requirements for Review Assist. The solution is intake-channel-agnostic to provide support regardless of the provider’s submission path.
Yes. One feature of the solution is an automated case summary, which draws on member clinical data to summarize foundational case information for quick case orientation.
Yes. In addition to the case summary mentioned above, Review Assist automates identification of the likely primary condition(s) to further inform nurses and accelerate reviews.