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Humana Partnership Streamlines Prior Authorizations Across 12 States

Using the CohereNext platform’s prior authorization capability grants authorizations across an entire episode of care, effectively pre-authorizing a patient’s complete treatment regimen from start to finish.

Humana is partnering with the healthcare tech company Cohere Health to grant authorizations across an entire episode of care for musculoskeletal treatment across 12 states starting January 1, 2021.

The CohereNext platform’s prior authorization capability grants authorizations across an entire episode of care, effectively pre-authorizing a patient’s complete treatment regimen from start to finish.

Humana will use the platform to streamline prior authorizations in musculoskeletal treatment in Alabama, Georgia, Indiana, Kentucky, Michigan, North Carolina, Ohio, Pennsylvania, South Carolina, Tennessee, Virginia, and West Virginia.

It will initially serve approximately 2 million members and more than 3,500 physician practices.

Published On: October 30th, 2020Categories: News

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About the Author: Cohere Health

Cohere Health is a clinical intelligence company delivering AI-powered intelligent prior authorization solutions, which streamlines patients’ access to quality care by aligning their physicians and health plans for improved collaboration, transparency, and care coordination. Cohere works with nearly 600,000 providers and processes more than 12 million prior authorization requests annually, using AI to auto-approve up to 90% of requests for millions of health plan members around the country. The company was recognized twice in the Gartner® Hype Cycle™ for U.S. Healthcare Payers, is a Top 5 LinkedIn™ Startup for 2023 & 2024, and is a three-time KLAS Points of Light award recipient. Its investors include Deerfield Management, Define Ventures, Flare Capital Partners, Longitude Capital, and Polaris Partners.