Cohere PaaS™ Intelligent Prior Authorization

Replace prior auth complexity with intelligence

Cohere helps health plans digitize the process and apply clinical intelligence to enable in-house, end-to-end automation of prior authorization. Health plans can directly license Cohere’s PaaS intelligent prior authorization for use by the plan’s internal utilization management staff.

As a result, our client health plans achieve both significant administrative efficiencies and faster, better patient outcomes. 

White paper

The tech-powered shift from transactional to transformational prior authorization

Read the white paper

Our solutions

Cohere delivers a tailored, modular, and configurable solution suite for health plans.

Cohere PaaS™

How Cohere PaaS™ works

Our intelligent digital technology reinvents the end-to-end prior authorization process

By bringing together responsible AI/machine learning and real-time analytics with deep, evidence-based clinical intelligence, Cohere enables the digital transformation of UM processes, driving greater operational efficiency, and most importantly, faster and better patient outcomes.

Cohere's solutions enable an end-to-end digitized prior authorization workflow

Automation Solutions

Prior authorization check
Completeness scan
Automated clinical review
Pended review pre-processing
Queue management
AI-assisted clinical review
Letter generation

Clinical Innovation Solutions

Trend management
Prior Authorization List (PAL) advisory
Care choice guidance
Policy optimization
Provider green lighting
Abuse detection
Early trend signal reporting
Personalized care path
Episodic authorizations
Care program links
Network intelligence & provider improvement
Outcomes measurement

Unify Intake + Unify Decisioning enable an end-to-end digitized prior authorization workflow.

Unify Transformation adds data analytics, clinical choice influence and care path/episodic models to evolve from a transaction focus to a care journey focus.

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.

Smart technology enables better results and experiences for your health plan and stakeholders

Health plan



in administrative costs



Satisfaction rate

+ NPS score of 65


Lower denial rate

without raising medical costs




access to patient care

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