Transformational solutions digitize preauthorization and add clinical intelligence to reduce administrative burden while driving faster, better care
boston, January 25, 2023 /PRNewswire/ — Cohere Health, a recognized leader in transformative prior authorization (PA) technology, today introduced Fog Unifi™, a health plan software-as-a-service solution suite that automates prior authorization intake and decision making using advanced analytics and AI/ML algorithms, adding transformative capabilities to accelerate and improve patient outcomes To increase administrative efficiency. This offering includes proven solutions across commercial, Medicare and Medicaid lines across National, Blue Cross Blue Shield and provider-sponsored health plans representing more than 15 million lives.
Prior authorization remains a heavy administrative burden for health plans and their provider partners, and can delay patient care. As a result, new state and CMS regulations will require a plan to automate and expedite PA. For forward-thinking plans, investing in compliance also presents an opportunity to improve the patient care journey and enable more successful value-based care arrangements. Cohere Unify provides intelligent pre-authorization solutions that enable regulatory compliance while improving patient experience and outcomes across the entire care journey.
“For too long, pre-authorization has relied on manual, disconnected processes that ultimately delay patients’ access to care,” said Siva Namasivayam, CEO of Cohere Health. “Cohere Unify applies advanced technology to remove the administrative and technical barriers that hinder seamless authorization. Beyond improving PA, Cohere Unify is clinical to enable the truly collaborative, optimal care journey Adds intelligence and advanced analytics, leading to better patient experiences and outcomes. Over 4.5 million PA requests transactions processed on Cohere Unify today, proving its scalability and successful implementation. Our solutions can be deployed immediately.
Cohere Unify can be licensed by health plans, at-risk health providers, and other organizations with UM operations using a software-as-a-solution approach. The suite supports all medical service types, and includes three different solutions that can be deployed together or standalone:
- cohair unified intake Digitizes and consolidates prior authorization requests across all sources to reduce health plan and provider administrative burdens. The solution converts fax requests into an electronic format, integrates with provider EHRs, and integrates with health plan authorization portals, enabling automated request input and clinical review.
- Cohair Unified Designing Ensures clean authorization requests and makes automated, real-time PA decisions based on the health plan’s preferred clinical policies, expediting manual clinical review when necessary. Together, these capabilities are proven to drive higher rates of instant approval, reduce turnaround time by 70% and administrative costs by 30-40%.
- fog unify Change Goes beyond traditional transaction-based PA by leveraging deep, evidence-based intelligence, AI and machine learning technology to improve quality of care while reducing denials without increasing costs. The solution also provides advanced clinical guidance to providers at the point of authorization, suggesting optimal care options based on patient group-specific data. Cohere Unify Transformation’s use of care paths and episodic authorizations enables stronger collaboration between health plans and providers by supporting the entire patient care journey, which enables more successful value-based care delivery and improved overall patient outcomes.
Cohere Unify is available immediately. Learn more about the components, features and options of the suite on Dedicated fog unified hub,
About Kohre Health
fog health A clinical intelligence company that provides intelligent prior authorization as a springboard to improved quality outcomes by aligning physicians and health plans on evidence-based care paths across a patient’s entire care journey, Fog’s intelligent prior authorization solution provides patient outcomes. Improve efficiency while reducing administrative costs. The company is a TripleTree iAward winner and has been named to both Fears Healthcare’s Fears 15 and CB Insights’ Digital Health 150 lists. Kohere’s investors include Flair Capital Partners, Define Ventures, deerfieldPolaris Partners, and Longitude Capital.
Amendola Communications for Cohere Health
source fog health