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Categories
Solutions
Description
Compatibility Level
Clients
Use cases
EHR integrations
Client types
Awards
Differentiators
Keywords
Media
Company details
Jump to:
Categories
Solutions
Description
Compatibility Level
Clients
Use cases
EHR integrations
Client types
Awards
Differentiators
Keywords
Media
Company details

Categories

Solutions

Description

Product Description:
  • Cohere Unify™ Intake: Digitizing and improving intake across fax, EMR, and portal
  • Cohere Unify™ Decisioning: Prior authorization check, completeness scan, automated clinical review, and pended review pre-processing
  • Cohere Unify™ Review: Queue management, AI-assisted manual review, and letter generation

About Cohere Health:

Cohere Health is a clinical intelligence company that provides intelligent prior authorization as a springboard to better quality outcomes by aligning physicians and health plans on evidence-based care paths for the patient's entire care journey. Cohere's intelligent prior authorization solutions reduce administrative expenses while improving patient outcomes. The company is a winner of the TripleTree iAward and has been named to both Fierce Healthcare's Fierce 15 and CB Insights' Digital Health 150 lists. Cohere's investors include Flare Capital Partners, Define Ventures, Deerfield, Polaris Partners, and Longitude Capital.

Product Description:
There’s a wealth of powerful data within your EHR—you just need real-time insights and seamless integration to make it actionable. Our Prior Authorization solution, powered by Waystar’s Hubble: - Automatically verifies, initiates, statuses and retrieves comprehensive authorization details - Enables efficient, intelligent automation by initiating authorizations at twice the speed of manual processes - Integrates directly with all major HIS and PM systems - Provides end-to-end authorization platform, including authorizations submissions for unscheduled admissions, as well as auto-generating ABNs or Notice of Non-coverage forms for Medical Necessity - Adapts to constantly shifting payer rules and requirements - Was built and is maintained by our in-house team of experts
About Waystar:

Waystar delivers innovative technology that simplifies and unifies healthcare payments. The company’s cloud-based platform helps healthcare providers across all care settings streamline workflows, improve financial performance and bring more transparency to the patient financial experience. Waystar solutions have been named Best in KLAS or Category Leader by KLAS Research 16 times (across multiple product categories) and earned multiple #1 rankings from Black Book. The Waystar platform is used by more than half a million providers, 1,000 health systems and hospitals, and 5,000 payers and health plans—and integrates with all major hospital information and practice management systems. On an annual basis, Waystar’s AI-powered solutions process $5B in patient payments, generate $4B in out-of-pocket estimates and process claims representing approximately 40% of the U.S. patient population. For more information, visit www.waystar.com.

Compatibility level

Select which hospital or health system you work at and see a personalized compatibility level.

Clients

Select which hospital or health system you work at and see the client list

Use Cases

Description:
  1. Submit Prior Authorization
  2. Check Prior Authorization status
Pediatric use cases:

None provided

Users:
  1. Physicians
  2. Administrative staff
  3. Billing staff
  4. Nurse practitioner
Description:

With over 300+ payers and a broad array of deployable service lines and patient types, we provide a full cycle automation solution for prior authorization: from pre-scheduled prior auth submission, status checking and denial prevention worklist alerts, as well as medical necessity verification and notification of admission.

Pediatric use cases:

None provided

Users:

Pre-service financial clearance teams, auth cert teams, any prior authorization staff doing medical necessity as well as authorization for services at acute care facilities or OP areas.

EHR Integrations

Integrations:

Other

EMR Integration & Relevant Hardware:

Recommended, but not required

EMRs Supported:

Epic

Hardware Compatibility:

None provided

Integrations:

None provided

EMR Integration & Relevant Hardware:

None provided

EMRs Supported:

None provided

Hardware Compatibility:

None provided

Client Types

Awards

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Differentiators

Differentiators vs EHR Functionality:

None provided

Differentiators vs Competitors:

The only UM platform designed to support in-house operations, or fully-delegated programs.

Whether a health plan is seeking to innovate their in-house UM operations or outsource utilizing a vendor partner for key service lines, Cohere is uniquely positioned to partner with them to build a path from digital transformation to true care collaboration.

  1. 25-40% reduction of administrative costs
  2. 65 NPS score among providers
  3. 70% faster access to patient care
  4. 15%+ medical cost savings beyond incumbent programs
Differentiators vs EHR Functionality:
Many hospitals, health systems, and IDNs have invested in billion dollar EMR/EMRs which are an extraordinary vehicle for clinical and billing functions -- but lack the ability to elevate automation in key business areas such as prior authorization. This is due to their lack of payer connections and the absence of advanced intelligent software. Together, Waystar brings the intelligence that powers today's EMR/EHR platforms and automation efforts.
Differentiators vs Competitors:
With nearly a decade in the business of automating prior authorizations, we are known for our internal expertise when it comes to payers, process change, and technology. We believe pushing the envelope in know-how across all 3 is what gives our clients the edge on automation. With more payer connections, more relationships with payers, and greater flexibility in accessing payer data we can access the best and most timely data. We not only seamlessly integrate with EPIC but offer full-stack integration capabilities or a powerful stand-alone application -- all because each patient access team is different. And powered across our Hubble platform (a blend of RPA, machine learning, NLP, and advanced auth rules) we are well positioned to power your automated enterprise.

Keywords

Images

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Videos

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Video: Cohere Unify

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Downloads

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Cohere Health Overview

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Alternatives

Company Details

Founded in 2000

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