The Cohere Unify Platform supports all of our intelligent prior authorization solutions with touchless and predictive technologies, evidence-based clinical content, and other advanced capabilities.
Our technologies reduce or eliminate manual steps toward creating an end-to-end fully automated prior authorization process.
Fax OCR digitization
Clinical decisioning engine
These innovative technologies enable prediction of the “next likely step” or “next best action.”
This predictive capability enables health plans to virtually eliminate prior authorization workflow steps. Instead, the system can automatically craft specific care plans based on patient and population auth and claims data, including multiple services that can all be pre-approved up front before they are even requested.
Multiple source data consolidation enabling a holistic patient clinical record
Simulation of next steps/next actions to aid in manual decisions
AI, including machine learning, to leverage consolidated data for automated guidance and decisioning
Analytics layer to present predictive and other insights in real time
Evidence-based clinical criteria for select specialties that inform our touchless and predictive technologies.
Advanced technical specifications
The Cohere Platform includes the latest technological capabilities and standards, including:
eliminates the need for internal hosting
compliant with FHIR, 278, and other widely-accepted standards
rules configuration and deployment proven to scale over multi-million+ transactions
proven single sign-on capabilities with Availity, NaviNet, and other common portal technologies
The tech-powered shift from transactional to transformational prior authorization
Cohere Unify’s innovative combination of AI technology, real-time analytics, and evidence-based clinical intelligence enables unique value for your health plan - beyond typical prior authorization solutions where unnecessary manual activity remains.
The absolute minimum amount of manual effort
By consolidating all requests into a single digital workflow, automating the application of all clinical and business rules, and using AI and machine learning to pre-process cases that still require clinical staff review.
Timely, complete regulatory compliance
By leveraging innovative technologies to automate decisioning, case pre-processing and rules transparency - so that your plan can meet new state and federal regulatory requirements concerning turnaround times, policy/decision transparency and gold carding.
Better and faster patient outcomes
By adding unique capabilities such as influence on care decisions prior to request submission, triggers for episodic vs. individual service authorizations, and care path models to optimize the entire care journey.