Drive **review efficiency** and accuracy with clinical-grade AI

Empower in-house clinical reviewers with AI-based automation and an extensive toolset.

Accelerate Clinical Reviews
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Accelerate Clinical Reviews

Accelerate reviews, improve quality, automate decision letters

Cohere Review Resolve leverages clinical-grade AI to drive efficient and high-quality medical necessity reviews, automating as many steps as possible and providing clinical intelligence to guide reviewers.

Boost efficiency

Reduce review times by an estimated 30-40% with AI-powered clinical insights. Give reviewers automated, clinically-appropriate information to streamline the manual review experience.

Improve accuracy

Automatically surface the appropriate guideline and leverage clinical AI with greater precision than off-the-shelf LLMs. Facilitate more accurate and complete medical necessity reviews with better decision quality.

Uncover hard-to-find indications

Start reviews with indication data surfaced by Cohere’s powerful clinical AI, proven to uncover clinical insights from unstructured (even hand-written) clinical records with far greater accuracy than off-the-shelf LLMs.

Dig deeper with clinical AI

Ask Casey, Cohere’s clinical AI chatbot, to assist in a deeper review–produce a highly-accurate case summary, explore trends over time, view suggested clinical queries, and more.

Complete determination workflows

Automate the generation of compliant determination letters, adding denial reasoning in the appropriate language with a few easy clicks.

How Review Resolve works

A comprehensive clinical toolset to increase the efficiency and accuracy of in-house medical necessity reviews

  • In-app guideline documentation

    Document reviews against the (automatically retrieved) appropriate guideline, viewed side-by-side with clinical records.

  • Indication data pre-surfaced by AI

    Begin reviews with clinical insights already uncovered to accelerate reviews and focus clinician attention where it’s needed.

  • Manual attachment highlighting

    Easily highlight data in clinical records and link it to the appropriate guideline to drive quality and support audits.

  • Clinical attachment viewer

    Easy navigation interface for source evidence, making it simple to review and verify clinical information.

  • AI chatbot agent

    Powerful AI-based chat experience that helps reviewers identify additional clinical insights and answer specific questions.

  • Letter generation

    AI-powered workflow to automate the creation of compliant determination letters with a few clicks.

Upgrade In-House Reviews

Estimated Impact

Cohere in action

  • 30-40%

    faster AI-assisted reviews

  • 30%

    estimated reduction in error rates

  • Accelerated

    review turnaround time

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Integrations

Unmatched EHR connectivity and UM interoperability

Tap into hundreds of hospitals and health systems processing touchless prior authorizations through Cohere's integration network and maximize your existing system investments.

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Bring AI to Your Clinical Reviews

**Join health plans** using Review Resolve

Reduce in-house reviewer burden, drive efficiency, and improve clinical decision quality.

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Bring AI to Your Clinical Reviews

Frequently asked questions

Get answers to common questions we hear from health plans looking to automate decisions while ensuring quality.

What makes the AI of Review Resolve more insightful than other automation solutions?

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.

Are there any limitations on which lines of business are supported by Review Resolve?

No, Review Resolve can be used to facilitate medical necessity reviews across all lines of business, including inpatient reviews.

Do authorization requests need to be made through a portal or EHR in order to be viewed in Review Resolve?

No, there are no special intake channel requirements for Review Resolve. The solution is intake-channel-agnostic to provide support regardless of the provider’s submission path.

Will Review Resolve provide reviewers with the necessary clinical context to guide reviews?

Yes. Casey, our powerful clinical AI assistant, can provide a detailed and accurate case summary, which draws on member clinical data to summarize foundational case information for quick case orientation.

Can Review Resolve help my teams identify the appropriate policy to guide decision-making?

Yes. Review Resolve automatically finds and surfaces the appropriate guideline to document against for medical necessity, saving clinician hours and driving accuracy.