Revolutionizing Prior Authorization: Cohere Health and Humana Expand Partnership to Include Diagnostic Imaging and Sleep Services

Cohere Health and Humana have announced an expansion of their 2021 partnership, with a focus on the prior authorization process for musculoskeletal issues. The partnership now includes diagnostic imaging and sleep services, in addition to the existing musculoskeletal services. The Cohere Unify Platform utilizes AI to accelerate the prior authorization process by utilizing predictive technology and clinical intelligence. This platform provides suggestions to providers before submitting requests in order to reduce denial rates from insurers.

Humana has rolled out Cohere’s offerings nationwide, adding cardiovascular and surgical services to the program last year. The latest expansion of the partnership will include diagnostic imaging and sleep solutions as part of the services Humana offers to its members and providers through Cohere Health. CEO of Cohere Health, Siva Namasivayam, expressed pleasure in Humana utilizing their diagnostic imaging and sleep solutions, enhancing the ongoing partnership.

Cohere’s solutions are based on evidence-based guidelines from medical societies and advanced technology to align patient services within care pathways to enable faster diagnoses. In February, Cohere secured $50 million in equity funding, bringing their total raise to $106 million. The company has rapidly grown since its launch, securing funding and partnerships along the way. Their partnership with Oracle aims to develop genAI services to automate business processes by combining Oracle’s cloud infrastructure with Cohere’s technology. Additionally, Cohere recently announced integration into Epic, allowing providers to submit prior authorizations directly into their EHR workflows.