Cohere Health Quickly Achieves 93% Digital Adoption for Blue Health Plan’s Prior Authorization Process

Intelligent Automation Reduces Burden for Providers and Accelerates Care Access

BOSTON (February 18, 2025) – Cohere Health®, the leader in clinical intelligence solutions for health plans, announced its prior authorization digital adoption results for a regional Blue affiliate health plan. The plan chose the Cohere Unify™ platform to improve provider satisfaction, accelerate time to care, and reduce administrative burdens with streamlined, automated prior authorization processes. Shortly after launch, the AI-powered platform helped the plan achieve 93% digital adoption by providers, significantly reducing time-consuming back-and-forth communications from fax- and phone-based prior authorization submissions.

Benefiting from the usability and national adoption of the Cohere Unify platform, the plan was able to reduce daily provider calls by one third. The plan’s UM operations team was also pleasantly surprised by the reduction in faxed-based communications from providers who embraced the Cohere platform. Reduction of fax volume–a cumbersome process for providers that adds to administrative costs and lengthy delays–was among the plan’s top goals, along with speeding up access to care.

Cohere Health’s Chief Experience Officer, Elif Eracar, added, “We’re excited to see such significant results so quickly. These results are in line with what we’re seeing on average: 96% digital adoption, 64% reduction in call volume, and 60% reduction in patient care delays. This is proof that Cohere is simplifying healthcare and moving prior authorization away from costly manual processes with automated, intelligent workflows.“

Cohere’s platform reduces or eliminates manual steps to create an end-to-end, fully automated prior authorization process for health plans. Using EMR integrations, digitization, and AI-powered guidance and workflows to help improve the experience for providers, Cohere has achieved a provider NPS of 64. The company also delivers evidence-based clinical criteria to support predictive decisioning and auto-approve requests, earning a 93% provider satisfaction rating for the experience.