Ensemble, the industry leader in end-to-end revenue cycle management (RCM), announced the launch of a transformational agentic AI platform for RCM in partnership with Cohere, the leading security-first enterprise AI company. This platform combines Cohere’s AI engineering expertise and robust security standards with Ensemble’s proven revenue cycle performance to elevate the results Ensemble delivers for hospitals and health systems — improving revenue yield, reducing friction and elevating the patient experience.
This marks the first healthcare deployment of Cohere North, a secure enterprise-grade agentic AI infrastructure, purpose-built for complex, regulated environments. Trained on over a decade of Ensemble’s award-winning performance data and embedded deeply within its operational workflows, the platform enables AI agents to reason, learn, and act across the full revenue cycle in real time.
“We’re integrating agentic orchestration into our end-to-end RCM model to ensure every action taken across the revenue cycle by our operators or agents reflects our proven best practices and highest performance standards,” said Judson Ivy, Founder and CEO of Ensemble. “Instead of training and deploying modular AI to address fragments of the revenue cycle, our clients get the benefit of AI-powered performance and rapid revenue improvement at scale from a single partner they can count on to deliver results.”
Enterprise AI Orchestration in Action
Unlike traditional vertical AI tools or agents that automate isolated tasks, Ensemble is integrating agentic capabilities horizontally across the entire revenue cycle, from front-end authorization and patient access to back-end collections and denials. These agents learn from every interaction, continuously reinforcing upstream improvements to reduce friction, prevent denials, and accelerate revenue.
The first network of agents, co-developed with Cohere, is focused on managing the most complex and fragmented part of the cycle — insurance reimbursement. Powered by advanced reasoning models and a human-in-the-loop safety framework, these agents can interpret account nuances, take multi-step actions, coordinate across Ensemble’s AI ecosystem and learn from operational feedback to successfully resolve accounts.
Initially, these agents are expected to manage at least 40% of AR follow-up tasks that previously required human intervention, with plans to scale significantly through reinforced learning. Ensemble has active pilots underway to deploy integrated agents to manage other complex processes, including authorization management, utilization management, coding and denial prevention.
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These agents orchestrate actions across Ensemble’s growing suite of AI-powered solutions, including clinically trained generative AI for denial appeals, conversational AI for patient engagement, predictive models to prevent denials, and agent assistants to support frontline staff. Together, these solutions are delivering significant results, including accelerating denial appeals by 40%, improving denial overturn rates by 15%, helping patients resolve inbound calls 35% faster and improving overall patient satisfaction.
Ensemble’s AI orchestration enhances the functionality of client host systems and ensures the electronic health record (EHR) system remains the source of truth by leveraging Ensemble’s data and operational excellence to deliver rich insights and actions. This approach delivers on the promise of Ensemble’s scale without sacrificing its clients’ significant EHR investments.
Powered by Cohere’s Secure AI Infrastructure
Ensemble selected Cohere for its unmatched ability to deploy secure, enterprise-grade AI in highly regulated environments. Cohere North enables Ensemble to build and deploy agents that integrate seamlessly with provider host systems, payer portals and internal tools — while maintaining HIPAA compliance and data security at every layer.
“Working with Ensemble to bring secure AI into healthcare — where data privacy is a deeply personal issue — is an incredible opportunity. Their industry leadership, data foundation, and forward-thinking approach make them an ideal partner to enter the industry,” said Ivan Zhang, Co-Founder of Cohere. “By working together, we’re setting a new standard for tackling some of healthcare’s toughest administrative challenges, and showing how agentic AI makes a real-world difference.”
Source: Globenewswire