Cohere Health is expanding the way it uses its prior-authorization platform in a continued partnership with its first client, Humana.
Cohere’s technology uses AI to accelerate the prior-authorization process and alleviate some of the administrative burdens on physicians. Prior authorization is a process through which physicians need to clear treatment plans with insurance companies before performing the treatment. Cohere says its technology helps physicians get the “yes” from payers faster.
Dr. Mary Krebs, a trained family physician and medical director of primary care at Cohere, says it's a big deal for providers.
“Physicians are all trying to do the right thing and do the best for their patients. We need to make that easier,” she said.
Cohere is expanding the clinical areas that its technology is used for, now including diagnostic imaging and sleep services.
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The expanded use of the platform comes after Cohere in February announced $50 million in new funding for its growth. Earlier this year, the Centers for Medicare and & Medicaid services finalized a rule requiring advancements in prior authorization applications. Cohere says its technology is a solution for those health plans needing to update.
Krishna Kottapalli, chief growth officer at Cohere, says the company is “maniacally focused on solving the prior authorization process.”
Cohere has grown significantly since its 2019 founding. In 2020, it has single-digit employees, and now employs over 700. It has about 50 physicians on staff, according to Kottapalli. The company’s customer base is payors, not providers, but its goal is to make the provider experience with prior authorization better.
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