What You Should Know:
– Cohere Health, a recognized leader in clinical intelligence and prior authorization automation, announced that Humana Inc. (NYSE: HUM) will expand its use of Cohere’s prior authorization platform for diagnostic imaging and sleep services.
– In January 2021, Cohere and Humana began a pilot program in 12 states to improve the prior authorization process for musculoskeletal (MSK) services.
Transformative Prior Authorization Solutions: Cohere’s Nationwide Impact on Healthcare Access and Provider Satisfaction
The program effectively decreased turnaround times for prior authorization approvals, boosted provider satisfaction, and improved care delivery for MSK services. This success led to expansion across all 50 states in 2022. In January 2023, Cohere’s solutions were rolled out nationwide, encompassing cardiovascular and surgical services.
Cohere’s prior authorization platform expedites the approval process for providers and patients. Its unique combination of real-time analytics and evidence-based clinical intelligence reduces denial rates and facilitates quicker patient access to care.
Annually, Cohere handles 5.5 million prior authorizations, benefiting over 15 million health plan members and 420,000 healthcare providers nationwide.
“We’re pleased Humana will be utilizing our diagnostic imaging and sleep solutions, further strengthening our strategic and ongoing partnership,” said Siva Namasivayam, Chief Executive Officer of Cohere Health. “Our solutions are rooted in the latest evidenced-based guidelines from leading medical societies and use advanced technology to align patient services within care pathways through upstream moments of influence, ultimately enabling faster diagnoses.”
