Leverage AI to transform
prior authorization

from transaction

to care journey

management

The problem

The prior auth maze can slow care access and hinder quality outcomes.

The answer

Cohere Unify™ Platform

Our solutions

Digitize the entire prior authorization process and drive better outcomes with the Cohere Unify™ Platform

Automation Solutions
Clinical Innovation Solutions
Submits through a single sign-on portal
Integrates with electronic medical records (EMR)
Digitizes fax submissions via optical character recognition (OCR) 
Scans with prior authorization check
Checks for missing info with a completeness scan 
Guides automated clinical review 
Prepares pended review pre-processing documentation for clinical review 
Prioritizes 100% of cases with automated queue management
Completes AI-assisted manual review 
Develops letter generation
Performs trend monitoring and management
Provides prior authorization list (PAL) recommendations.
Deploys care choice guidance 
Identifies clinical policy optimization
Enables provider green lighting
Alerts on abuse detection
Reports early trend signals
Generates personalized care path authorizations
Bundles requests into episodic authorizations
Identifies care program links 
Provides network intelligence and provider improvement
Delivers outcomes measurement reports
Cohere Unify™ Platform
Cohere PaaS™
Cohere Complete™
Cohere
PaaS™
Cohere
Complete™
Cohere
Unify™ Platform

Cohere Unify™ Platform

The Cohere Unify Platform incorporates artificial intelligence/machine learning, rules, and advanced analytics engines, plus current integration/interoperability capabilities (including FHIR), to drive Cohere’s innovative, end-to-end capabilities.
Cohere Unify™ Platform

There are two delivery options for the Cohere Unify Platform.

Cohere PaaS™

Cohere PaaS™

Cohere Complete™

For select medical specialties, Cohere Complete provides a fully outsourced, delegated service to manage a health plan’s entire UM operations.
Cohere Complete

Our capabilities have driven these unique, actual results

Our capabilities have driven these unique, actual results

70%

Faster

access to patient care

Driven by real-time clinical intelligence at the point of diagnosis
63%

Decrease

in denial rates

Driven by evidence-based intelligence that guides clinically appropriate requests before submission
18-43%

Decrease

in adverse outcomes

Driven by AI/ML-based clinical suggestions (“nudges”) and analytic features in the prior authorization workflow

Get started with Cohere

Accreditations

Awards

See a real story of how our approach to prior authorization improves patient outcomes while also saving time and cost.

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