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AI-powered prior authorization automation

Touchless prior authorizations and faster medical necessity reviews, with up to 18x return on investment.

Offerings

Run UM with your own clinical team

Specialty-specific care management

Embed UM into existing systems

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

Run payment integrity internally

Fully managed audit operations

Reconcile claims against authorizations

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

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

Explore Platform

Automated claims rule management

Automatically maintain claims rules and drive more accurate claim outcomes across the payment lifecycle.

Explore Claims Operations

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

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.

Offerings

Run UM with your own clinical team

Specialty-specific care management

Embed UM into existing systems

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

Run payment integrity internally

Fully managed audit operations

Reconcile claims against authorizations

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

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

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.

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

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Our experts share insights on trends impacting utilization management and payment integrity.

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Navigate healthcare AI with clarity

Resources

Our experts share insights on trends impacting utilization management and payment integrity.

Press Blog Customer Success Stories Resource Center Glossary Events AI Hub

Case study

Explore the Humana experience

Resources

Our experts share insights on trends impacting utilization management and payment integrity.

Press Blog Customer Success Stories Resource Center Glossary Events AI Hub

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Provider experience survey video cover graphic

Survey data reveals the hidden cost of manual prior authorization

AI mythbusters video cover graphic

AI Myths in Prior Authorization: Separating Fact from Fear

Cohere Unify Short platform overview video cover graphic

What Is Cohere Unify? A Connected Approach to Healthcare Operations

How Cohere Health helps health plans video cover graphic

Cohere Unify: One source of clinical truth across the care continuum

Humana Case Study Video Cover Graphic

How Humana Turned Prior Authorization Into a Care Planning Advantage

How to approach policy digitization and automation - The Cohere way video graphic

Turning Policy Chaos Into Faster Prior Authorization Decisions

Cohere Health's utilization management capabilities video cover graphic

Turning prior authorization from a bottleneck into a bridge to care

Cohere's Provider Experience video cover graphic

How Cohere Health Eases Prior Authorization Burden for Providers

How clinical expertise is applied to drive appropriate care choices video cover graphic

Where clinical expertise meets smarter care decisions

Cohere Unify Platform Overview Video

Cohere Unify: connecting healthcare operations through clinical intelligence

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