Methods, systems, and computer program products for selecting criteria subsets for performing a medical necessity review with automatic evidence highlighting

Abstract

A method includes receiving input information associated with a health record of a patient, the input information comprising a plurality of input variable tokens; embedding the plurality of input variable tokens to generate a plurality of input variable token vectors, respectively; aggregating the plurality of input variable token vectors to generate a patient health record vector; generating, using an artificial intelligence model, an identification of a criterion used for determining an appropriateness of a care plan for the patient based on the patient health record vector; and generating a ranking of respective ones of the plurality of input variable tokens based on how much each of the plurality of input variable tokens contributed to the identification of the criterion.