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

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Categories

Solutions

Description

Product Description:
  • Janus Health Prior Authorization supports the full auth process, from determination to statusing.
  • Seamless EHR integration enables your team to operate within their established workflows, maximizing efficiency and boosting employee satisfaction. Intelligent automations allow staff to avoid unnecessary follow-up, working only those auths that demand attention. Plus, cover more of your specialties like radiology, cardiology, surgery, and more, across ~80% of your payer mix.
  • Experience enhanced operational efficiencies that support employee retention, save valuable staff time, and reduce authorization-related denials, increasing revenue and reducing cost-to-collect.

About Janus Health:

Janus Health is fundamentally transforming the future of revenue cycle work with our groundbreaking end-to-end artificial intelligence platform. Our rich history in healthcare and technology allows us to instinctively understand what it is about revenue cycle management that creates significant challenges for healthcare organizations. We’ve developed Operational Intelligence and Intelligent Automation solutions to aid revenue cycle teams in optimizing their workflows, so they can do more with less and ultimately collect more cash.

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

Product Capabilities

An unattended automation is initiated from the EHR, determines whether an auth is required, and returns the response to the EHR. From there a user can initiate the submission workflow, if needed.

We leverage real-time automations instead of relying on a quickly outdated rule library, allowing us to keep up with the payer landscape and prior authorization changes. We can develop some client-specific rules per automation.

Leveraging Janus Health Teleport, Prior Authorization automates navigation to the authorizing payer or portal to the point where human intervention (clinical documentation upload and submission) is required.

An unattended automation checks the status of submitted authorizations and returns it to the EHR.

Use Cases

Description:

Prior Authorization automates auth determination at scheduling, so patient access staff only touches those accounts requiring authorization submission.

Pediatric use cases:

None provided

Users:

Patient access specialist

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:

Acute care EMR

EMR Integration & Relevant Hardware:

None provided

EMRs Supported:

Epic

Hardware Compatibility:

None provided

Integrations:

Other

EMR Integration & Relevant Hardware:

Recommended, but not required

EMRs Supported:

Epic

Hardware Compatibility:

None provided

Client Types

Awards

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Differentiators

Differentiators vs EHR Functionality:
  • Broad payer and specialty coverage, driven by providers' needs (not payer sponsorship)
  • >80% of payer mix
  • Teleport streamlines auth initiation
Differentiators vs Competitors:
  • Broad payer and specialty coverage, driven by providers' needs (not payer sponsorship)
  • >80% of payer mix
  • Teleport streamlines auth initiation
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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Video: Cohere Unify

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Cohere Health Overview

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Company Details

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