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

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Categories

Solutions

Description

Product Description:

Get faster prior auth approvals using artificial intelligence and automation with exception handling by specialists.

About Infinx:

Infinx Healthcare provides tech-enabled patient access and revenue cycle management solutions for providers, hospitals and health systems. Combining technology like artificial intelligence, automation and workforce management, with exception handling by our skilled patient access, clinical, coding, billing and compliance specialists, we help clients preserve and capture more reimbursements and expand operating margins. 

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.

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:

In a recent survey, AMA reported a staggering 86% of providers felt that the mechanics of administering prior authorization processing is a burden, 91% felt that it caused patient care delays and 82% reported that the number of prior authorizations required for medical services increased over the last 5 years.

While the healthcare industry is working towards implementing standard electronic prior authorization processing guidelines, it is no secret that in the foreseeable future, providers will still find the process of obtaining prior auth approvals burdensome causing patient care frustrations, delays and abandonment.

Pediatric use cases:

None provided

Users:

Providers, Administrators

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

EHR Integrations

Integrations:

None provided

EMR Integration & Relevant Hardware:

None provided

EMRs Supported:

Epic, Cerner

Hardware Compatibility:

None provided

Integrations:

Other

EMR Integration & Relevant Hardware:

Recommended, but not required

EMRs Supported:

Epic

Hardware Compatibility:

None provided

Client Types

None provided

Awards

No awards image
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Differentiators

Differentiators vs EHR Functionality:

Prior Authorizations Accelerated by AI and Automation

Our cloud-based, AI-powered prior authorization software provides a complete patient access solution for healthcare providers by leveraging the latest machine learning, artificial intelligence and automation technology with exception handling by our experienced billing specialists.

Requests requiring a prior authorization are initiated electronically to the appropriate payer. Complex requests and exceptions are handled by our team of certified specialists to provide you with complete coverage of your prior authorization claim.

Status notifications are communicated in real-time through automated follow-ups by robotic process automation (RPA). Our RPA bots repeatedly check requests under review for status change updates.

We provide you with complete coverage of your prior authorization requests with a 98+% accuracy and 99.5% adherence to turnaround times. No more auth requests getting kicked back to you due to lack of information. We take care of it for you.

Differentiators vs Competitors:

Provider Integration

Submit and update your prior authorization requests directly from your local EHR/EMR using either an API or HL7 based bi-directional integration.

Authorization Determination Engine

Determine if your request requires a prior authorization using the Authorization Determination Engine, built using machine learning.

Unified Workflow Experience

Perform all prior authorization related functions on a unified web portal, built to offer you an intuitive and seamless experience.

Automated Authorization Follow-up

Keep up with the status of an initiated prior authorization claim using automated authorization follow-up.

Analytics and Reporting

Obtain full transparency into your prior authorization process using detailed and robust analytics and reporting.

Alerts and Notifications

Receive constant alerts and notifications pertaining your prior authorization claim, which includes all updates and payer communications

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

Keywords

Images

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Videos

1 of 3

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1 of 1

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Video: Cohere Unify

Downloads

https://www.infinx.com/white-paper/positively-impact-orthopedics-revenue-with-artificial-intelligence-and-automation/
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Cohere Health Overview

Alternatives

Company Details

Founded in 1979

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