Intelligent Prior Authorization

Digitize prior authorization and improve care quality

Solutions that foster
collaboration, not abrasion.

Cohere leverages an innovative blend of AI and machine learning, deep, evidence-based clinical expertise, and real-time analytics, not only to digitize prior authorization, but also to guide the best and fastest care across the entire patient journey.

Lower administrative costs for your health plan

Less abrasion and faster turnaround for your providers

Faster and better outcomes for patients

Our Solutions

Cohere Unify™ intelligent prior authorization solutions

Digitizes authorization requests from all sources into a single automated workflow
Automates authorization decisioning using plan-preferred policies
Leverages data, analytics and care paths to improve the entire care journey
Cohere
Complete™
Specialty-Specific Clinicians
Ongoing Analytics
Flexible Policy Options
Cohere
Unify™
Cohere
Complete™
Cohere offers the only platform that can be licensed for in-house use, or leveraged as part of a fully delegated service.
Cohere Unify
Cohere Complete

All supported by the Cohere Platform

The Cohere Platform drives automated workflows, analytic insights, and interoperability through the use of advanced technologies, including AI and machine learning.

Workflow

Our Decisioning Engine stores and deploys your plan’s administrative and clinical rules that govern prior authorization decisions.

Analytics

Our Analytics Layer drives clinical and network intelligence, including signals-based and predictive analytics, to further improve provider and patient experience.

Interoperability

The Cohere Platform enables interoperability with all related provider and payer IT systems, including EHRs and UM systems, via FHIR, 278, SSO, and other widely accepted standards.

The ROI of a better approach - actuarially verified 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

Case Study

Learn How Humana Transformed Prior Authorization to Improve Care & Collaboration

Read the Case Study

Ready to Learn More?

Contact Us Today