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flag AI platform cuts utilization management workload by up to 60%, speeds reviews, ensures compliance.

flag GenHealth.ai and Guidehealth reported up to a 60% reduction in utilization management workload using an AI-native platform that automates data extraction from diverse sources and applies clinical and administrative policies. flag The system generates decisions with over 90% consistency, saves an average of one hour per skilled nursing facility case, and completes reviews in under ten minutes. flag It ensures compliance with CMS, NCQA, and state regulations through detailed citations and transparent, auditable outputs. flag The pilot processed thousands of cases across multiple care settings, with plans to expand into behavioral health and substance use disorder services.

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