BOSTON (February 3, 2022) – Today Cohere Health, a utilization management technology company, announced that it has processed its one millionth prior authorization request for medical services.
Cohere reached this landmark less than 12 months after processing its first request via its intelligent authorization platform, which improves health plan and provider collaboration in order to reduce treatment delays and improve patient outcomes. The Cohere platform automates both provider and payer steps in the authorization process, coupling AI and machine learning with evidence-based clinical policy to support better care decisions.
“By facilitating clear communication and transparency at the moment of authorization, we’re successfully aligning physicians and health plans on their ultimate priority: better care management,” said Siva Namasivayam, co-founder and CEO of Cohere Health. “We’re thrilled to play a role in improving the care experience for so many patients, and we’re looking forward to hitting that second million milestone even faster than the first.”
Cohere’s platform treats the ordering physician as a partner, offering helpful, evidence-based suggestions to guide clinically appropriate requests before submission. Instead of limiting an authorization request to procedure-related information, the platform suggests pre-approved care pathways that support the entire care episode, which reduces the time spent on authorizations and enables better patient outcomes. As a result, patients are able to access appropriate care four days faster than before. The upfront focus on clinical best practices and reduced care variation has helped drive a 63% decrease in denial rates, without increasing costs.
“Typically, an episode of care can require separate authorization for six or more separate services, which creates an unnecessary administrative burden for everyone involved and puts health plans at odds with physicians,” said Duncan Reece, co-founder and COO of Cohere Health. “Our platform changes that dynamic. By providing technology that allows physicians and health plans to collaborate on a high-quality, high-value care plan, we’re recentering utilization management on the patient’s needs.”
As a digital healthcare company founded in 2019, Cohere has enjoyed record growth in the past year, expanding its headcount significantly. Now with more than 400 employees, the company recently moved its headquarters to an office space in downtown Boston.
In January, Cohere was named to Fierce Healthcare’s 2022 Fierce 15 list, a selection of the most innovative private healthcare companies in the industry. The company also won the 2021 TripleTree iAward for delivering meaningful solutions that improve healthcare for consumers, providers and payers, and was included on the 2021 CB Insights Digital Health 150 list as one of the most promising digital health startups in the world.
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