Cohere PaaS Intelligent Prior Authorization Description

Cohere assists health plans in transforming their processes by integrating clinical intelligence, which facilitates comprehensive automation of prior authorization internally. Health plans can license Cohere's PaaS for intelligent prior authorization directly, allowing their utilization management teams to utilize it seamlessly. Consequently, client health plans experience notable improvements in administrative efficiency, alongside enhanced patient outcomes that are both quicker and more effective. Cohere offers a customized, modular solution suite specifically designed for health plans, streamlining all prior authorization requests into a cohesive, automated workflow. The platform automates decisions regarding prior authorizations based on the policies preferred by the health plans and accelerates the manual review process. It also aids clinical reviewers in handling complex requests with the help of responsible AI/ML and its automated features. By harnessing clinical intelligence through AI/ML and sophisticated analytics, Cohere enhances the performance of utilization management. Furthermore, it contributes to improved patient and population health outcomes through innovative programs tailored to specific specialties. This comprehensive approach positions Cohere as a leader in the health technology space, ensuring that health plans can meet their operational goals effectively.

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The Cohere Unify platform enhances all of our intelligent prior authorization solutions through the integration of touchless and predictive technologies, clinical content grounded in evidence, and various advanced features. By leveraging these technologies, we significantly minimize or completely remove the manual processes involved in achieving a comprehensive, fully automated prior authorization workflow. This predictive functionality allows health plans to nearly eradicate the traditional steps associated with prior authorization processes. Consequently, the system can autonomously generate tailored care plans utilizing patient and population authorization and claims data, which includes the ability to pre-approve multiple services before any requests are made. We employ evidence-based clinical criteria for specific specialties that complement our touchless and predictive technologies. Additionally, our platform features reliable single sign-on capabilities with widely used portals such as Availity and NaviNet. Furthermore, the configuration and implementation of rules have been validated to effectively manage transactions involving millions of cases, showcasing the scalability of our system. Ultimately, this innovative approach streamlines healthcare operations while enhancing efficiency and accuracy.
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Company Details

Company:
Cohere Health
Headquarters:
United States
Website:
coherehealth.com/paas

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Cohere PaaS Intelligent Prior Authorization Screenshot 1
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