Question: I'm looking for a platform that uses AI and machine learning to improve the accuracy and efficiency of utilization management in healthcare.

If you're looking for a platform that uses AI and machine learning to improve the accuracy and efficiency of utilization management in healthcare, Cohere Health offers a comprehensive solution. Their platform, Cohere Unify, transforms prior authorization processes by automating decisions, digitizing requests, and integrating with EMRs and fax submissions. It also offers AI-assisted manual review, automated queue management, and specialty-specific programs to improve patient and population outcomes.

Another strong contender is Qventus, which uses AI, machine learning, and behavioral science to optimize patient flow and operational performance. It integrates with EHR workflows to automate processes and provide actionable insights, helping to streamline surgical scheduling, discharge planning, and overall operational efficiency. Qventus has reported significant results, including a 6x ROI and a reduction in length of stay.

Inovalon provides a cloud-based platform that offers advanced analytics and business intelligence to enhance patient care and outcomes. It includes tools for optimizing revenue cycle management, care quality management, and workforce management, making it a versatile option for improving healthcare economics. Inovalon supports nearly 20,000 customers across 53,000 sites of care, demonstrating its broad impact on the healthcare industry.

Lastly, Availity offers an integrated provider engagement platform that simplifies administrative and clinical workflows. It features AI-powered prior authorization, revenue cycle management, and denial prevention and management tools. Availity processes over 13 billion transactions annually, making it a robust solution for improving patient care and operational efficiency.