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
Our intelligent digital technology reinvents the end-to-end prior authorization process
By bringing together intelligent authorization intake, AI/machine learning, and real-time analytics with deep, evidence-based clinical intelligence, Cohere Unify enables the digital transformation of UM processes, driving greater operational efficiency, and most importantly, faster and better patient outcomes.
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 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.
Unify Results Smart technology enables better results and experiences for your health plan and stakeholders
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
Unify’s Unique Value
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