The problem

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

The answer

Cohere Unify™ Platform

Our AI thought leadership articles

Rethinking preventative healthcare with AI and population data

November 27, 2023

AI is already transforming prior authorization

September 29, 2023

Forecasting healthier tomorrows: The predictive power of AI and patient data

September 21, 2023

AI guardrails that can eliminate PA denial nightmares

August 3, 2023

Health care’s quest for responsible innovation

August 23, 2023

Future proofing healthcare automation: Constructing a responsible AI framework for prior authorization

September 28, 2023

Discover our AI-powered outcomes

Automation Solutions

Clinical Innovation Solutions

digitizes all prior authorization requests into a single automated workflow.

Submits through a single sign-on portal

Integrates with electronic medical records (EMR)

Digitizes fax submissions via optical character recognition (OCR)

automates prior authorization decisions using health plan-preferred policies and accelerates manual review.

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

assists clinical reviewers, using responsible AI/ML and automated capabilities.

Prioritizes 100% of cases with automated queue management

Completes AI-assisted manual review

Develops letter generation

leverages clinical intelligence to improve utilization management performance.

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

improves patient and population outcomes with innovative, specialty-specific programs.

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

drives Cohere's advanced capabilities with innovative technology and design

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.

enables health plans to license any of Cohere's platform as a service (PaaS) for use by the plan's internal UM staff.

includes all of our solutions, plus intake and clinical staff, to provide fully outsourced and delegated specialty UM services.

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

Cohere Complete

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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