Cohere Unify™ Intelligent Prior Authorization

Replace prior auth complexity with intelligence

Cohere Unify intelligent prior authorization solutions digitize the process and apply clinical intelligence to enable in-house, end-to-end automation of prior authorization. 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

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

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

Data Analytics

Care Path/Episodic Models

Clinical Choice Influence

Cohere
Unify™

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

The Cohere Platform supports Cohere Unify and Cohere Complete 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.

Health Plan

25-40%

Reduction

in administrative costs

Provider

92%

Satisfaction rate

+ NPS score of 55

63%

Lower denial rate

without raising medical costs

Patients

70%

Faster

access to patient care

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.

White Paper

The Tech-Powered Shift from Transactional to Transformational Prior Authorization

Read the White Paper

Cohere Unify™ Intelligent Prior Authorization

Replace prior auth complexity with intelligence

White Paper

The Tech-Powered Shift from Transactional to Transformational Prior Authorization

Unify Solutions

Cohere Unify is a modular, configurable solution suite tailored to your health plan’s specific prior authorization requirements

Intake

Decisioning

Transformation

How Unify Works

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

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.

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.

Intake

Decisioning

Transformation

All supported by the Cohere Platform

Touchless Technologies

Predictive Technologies

Advanced Technical Specifications

Unify ResultsSmart technology enables better results and experiences for your health plan and stakeholders

Health Plan

Reduction

in administrative costs

Provider

Satisfaction rate

+ NPS score of 55

Lower denial rate

without raising medical costs

Patients

Faster

access to patient care

Unify’s Unique Value

The absolute minimum amount of manual effort

Timely, complete regulatory compliance

Better and faster patient outcomes

White Paper

The Tech-Powered Shift from Transactional to Transformational Prior Authorization

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