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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
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
Explore Platform
Automated claims rule management
Automatically maintain claims rules and drive more accurate claim outcomes across the payment lifecycle.
Explore Claims Operations
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
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
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
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
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
Blog
Hybrid season is over: Why year-round quality measurement is the new reality
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Why AI change management determines health plan integration success
Keeping embedded AI accountable as health plans scale
Choosing the right AI partner for governed, scalable AI
See how Cohere Surface™ brings transparency to payment integrity
Why enterprise integration is the real test for healthcare AI
Survey data reveals the hidden cost of manual prior authorization
AI myths in prior authorization: Separating fact from fear
How Humana turned Prior authorization into a care planning advantage
Turning policy chaos Into faster prior authorization decisions
Turning prior authorization from a bottleneck into a bridge to care
How Cohere Health Eases Prior Authorization Burden for Providers
Where clinical expertise meets smarter care decisions
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