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AI-powered prior authorization automation
Touchless prior authorizations and faster medical necessity reviews, with up to 18x return on investment.
Explore UM
Offerings
In-House
Run UM with your own clinical team
Delegated
Specialty-specific care management
API-Based
Embed UM into existing systems
Policy Studio
Manage clinical policy at scale
Flexible, connected payment integrity
Catch errors upstream and reduce post-pay disputes with a 9x return on investment.
Explore Payment Integrity
Offerings
In-House
Run payment integrity internally
Services
Fully managed audit operations
Auth Match
Reconcile claims against authorizations
Data Mining
Surface high-value audit targets
Streamlined appeals workflows
AI-assisted review and evidence gathering help reviewers complete appeals in half the time, with full auditability.
Explore Appeals
Cover
Press

Cohere Unify expands into appeals: reviewers close cases in half the time

Connected clinical intelligence
Surface rising-risk members, close care gaps, and generate compliant care plans within existing workflows.
Explore Care Management
How Cohere Unify surfaces rising-risk members and closes care gaps
Healthcare platform screen showing approved lumbar decompression authorization and patient details form.
Explore Platform
Automated claims rule management
Automatically maintain claims rules and drive more accurate claim outcomes across the payment lifecycle.
Explore Claims Operations
Cover
Press

Cohere Surface brings transparency to claims data mining

AI-powered clinical evidence extraction
Automated HEDIS gap closure across unstructured records, with 20–25% closure rates for high-value measures.
Explore Quality
Graphic reading: Hybrid season is over: Why year-round quality measurement is the new reality.
Blog

Hybrid season is over: Why year-round quality measurement is the new reality

Utilization Management
+
AI-powered prior authorization automation
Touchless prior authorizations and faster medical necessity reviews, with up to 18x return on investment.
Explore UM
Offerings
In-House
Run UM with your own clinical team
Delegated
Specialty-specific care management
API-Based
Embed UM into existing systems
Policy Studio
Manage clinical policy at scale
Payment Integrity
+
Flexible, connected payment integrity
Catch errors upstream and reduce post-pay disputes with a 9x return on investment.
Explore Payment Integrity
Offerings
In-House
Run payment integrity internally
Services
Fully managed audit operations
Auth Match
Reconcile claims against authorizations
Data Mining
Surface high-value audit targets
Appeals
+
Streamlined appeals workflows
AI-assisted review and evidence gathering help reviewers complete appeals in half the time, with full auditability.
Explore Appeals
Cover
Press

Cohere Unify expands into appeals: reviewers close cases in half the time

Care Management
+
Connected clinical intelligence
Surface rising-risk members, close care gaps, and generate compliant care plans within existing workflows.
Explore Care Management
How Cohere Unify surfaces rising-risk members and closes care gaps
Healthcare platform screen showing approved lumbar decompression authorization and patient details form.
Explore Platform
Claims Operations
+
Automated claims rule management
Automatically maintain claims rules and drive more accurate claim outcomes across the payment lifecycle.
Explore Claims Operations
Cover
Press

Cohere Surface brings transparency to claims data mining

Quality
+
AI-powered clinical evidence extraction
Automated HEDIS gap closure across unstructured records, with 20–25% closure rates for high-value measures.
Explore Quality
Graphic reading: Hybrid season is over: Why year-round quality measurement is the new reality.
Blog

Hybrid season is over: Why year-round quality measurement is the new reality

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Electronic Letter Consent

Effective Date: 3/5/2021

By selecting the checkbox you, the provider, request and consent to receive all Cohere Health UM determination notifications electronically. As permitted per state and federal regulation, you will not receive paper based member notifications from Cohere Health so long as this delivery method has been selected. Should you need a paper copy of a notification, you can download a PDF copy of the member notification from the CohereNext platform. You may withdraw this consent at any time by having your organization admin select Paperless Settings under the My Account menu. Once we have received your request, you will be re-enrolled in paper based notifications within one (1) business day. It is the ordering provider’s responsibility to regularly check the CohereNext platform, which is accessible 24/7, to view authorization decisions or download a PDF copy of the notification.

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