Intelligent Prior Authorization

Digitize prior authorization and improve care quality

Solutions that foster
collaboration, not abrasion.

Cohere leverages an innovative blend of responsible AI and machine learning, deep, evidence-based clinical expertise, and real-time analytics, not only to digitize the process, but to also 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 your members

Our solutions

Cohere’s Automation Solutions digitize and streamline manual prior authorization processes, enabling Clinical Innovation Solutions to apply AI/ML to data and influence the end-to-end patient journey.
Health plans have the option to directly license any of Cohere’s solutions for use by the plan’s internal UM staff.
Cohere PaaS™
Health plans can also choose to outsource fully delegated services to Cohere to manage the plan’s entire UM operations for selected specialties.
Cohere Complete™

All supported by the Cohere Unify™ Platform

The Cohere Unify Platform supports Cohere PaaS and Cohere Complete solutions with touchless and predictive technologies, evidence-based clinical content, and other advanced technical specifications.

Touchless technologies

Reduces or eliminates manual steps toward creating an end-to-end fully automated prior authorization process.

Predictive technologies

Predicts the “next likely step” or “next best action” to virtually eliminate prior authorization workflow steps and automatically craft specific evidence-based patient care plans that are clinically appropriate.

Advanced technical specifications

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



access to patient care

Driven by real-time clinical intelligence at the point of diagnosis


in denial rates

Driven by evidence-based intelligence that guides clinically appropriate requests before submission


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

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