CMS tech rules and AI benefits for primary care, patients and ‘touchless’ prior auths
Published:
August 21, 2026
This article is Part 3 of a three-part conversation with Cohere Health Chief Medical Officer Dr. Brian Covino. Read Part 1 here and Part 2 here.
“Knowing that it’s your doctor–or someone just like your doctor–developing this technology alongside engineers can provide comfort that it will be accurate, trustworthy, and beneficial.”
In the final installment of this three-part series with Medical Economics, Dr. Brian Covino explores how AI can transform prior authorization (PA) into a seamless, patient-centered process. By embedding clinical guidelines from medical societies into AI-powered decision-making, health plans can achieve scalable, automated approvals in high-volume specialties. Dr. Covino shares how greater interoperability supports “touchless authorizations,” where physicians and their teams can extract clinical data directly from the EHR, enabling real-time approvals before a patient even leaves the office. He emphasizes that overcoming AI skepticism–both from physicians and patients–needs technology co-developed with clinicians to ensure accuracy, transparency, and trust, paving the way for continued measurable improvements.
Key points discussed:
- High-volume specialties like orthopedics, cardiology, and imaging benefit most from scalable, digitized appropriate-use criteria
- The vision for "touchless authorization" that allows EHR systems to automatically communicate with health plans and return real-time approvals during a patient's visit
- The importance of physician co-development in mitigating patient and provider skepticism surrounding engineering-driven AI tools in healthcare
Written by
Brian
Covino, M.D., FAAOS
Dr. Brian Covino is Chief Medical Officer at Cohere Health, bringing over 25 years of experience as a practicing orthopaedic surgeon, serving as a partner at Knoxville Orthopaedic Clinic, and directing the value-based care program at OrthoTennessee. He holds a bachelor’s degree from Harvard University and an M.D./M.S. from Georgetown University School of Medicine. Dr. Covino completed his surgical training at the University of Virginia and a fellowship at The Cleveland Clinic Foundation. He served as Co-Director of Parkwest Medical Center’s Joint Replacement Center and was among the "Best Doctors in America" for 20+ consecutive years.
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