We combine health plan-preferred policies with advanced AI to deliver automated approvals for up to 90% of submissions while reducing appeals and overturns.
Up to 90% automated authorization decisions
More than 350 proprietary AI/ML models
Up to 47% administrative savings
Tailored decisioning against health plan business rules
Our AI-powered automation handles the majority of prior authorization decisions
Our AI-powered automation handles the majority of prior authorization decisions, freeing your team to focus on complex cases that truly require human expertise. With approval rates of 50-90% depending on specialty, you'll see immediate impact on operational efficiency.
Unlike other solutions, Cohere Decision combs through structured and unstructured clinical records to identify medical necessity data. Our clinically-trained AI sources this information with greater accuracy than off-the-shelf LLMs and even experienced UM nurses.
Cohere offers expert digitization services to ensure every automated decision aligns perfectly with your coverage guidelines and clinical standards. Our solution decisions against NCDs, LCDs, Cohere proprietary guidelines, custom health plan medical policies, and even third-party guideline vendor policies (with mutual agreement by the third party).
350+
proprietary AI/ML models deployed
50-90%
of authorizations automated (varies by specialty)
47%
administrative savings
Integrations
Cohere Decision works within your technology ecosystem, connecting with major EHR systems, UM systems, and administrative tools to ensure smooth data flow and minimal disruption to existing workflows.
Join leading health plans that have automated up to 90% of their prior auth decisions while reducing administrative costs by nearly half.
Get answers to common questions we hear from health plans looking to automate decisions while ensuring quality.
Cohere Unify Platform
Cohere Decision is part of a comprehensive platform that transforms the entire authorization ecosystem for both providers and payers.
