Prior authorization automation platform Cohere Health and health insurer Humana announced they are expanding their 2021 partnership, which focused on the prior authorization process for musculoskeletal issues, to include diagnostic imaging and sleep services.
The Cohere Unify Platform leverages AI to accelerate the prior authorization process by using predictive technology and clinical intelligence. The platform gives providers suggestions before submitting requests, aiming to lower insurers’ denial rates.
In 2021, the companies launched their partnership with a pilot program focused on musculoskeletal services. The pilot took place in 12 states initially and expanded to all 50 states a year later after the companies said it showed promise.
Last year, Humana deployed Cohere’s offerings nationwide and added cardiovascular and surgical services to the program.
Through the expanded partnership announced this week, diagnostic imaging and sleep solutions will be added to the services Humana offers its members and providers through the clinical intelligence company.
“We’re pleased Humana will be utilizing our diagnostic imaging and sleep solutions, further strengthening our strategic and ongoing partnership,” Siva Namasivayam, CEO of Cohere Health, said in a statement.
“Our solutions are rooted in the latest evidenced-based guidelines from leading medical societies and use advanced technology to align patient services within care pathways through upstream moments of influence, ultimately enabling faster diagnoses.”
THE LARGER TREND
In February, Cohere secured $50 million in equity funding, bringing its total raise to $106 million. In 2021, less than a year after the company officially launched, it secured $36 million in Series B funding. The year before, it raised $20 million over two funding rounds.
Earlier this month, Cohere announced it was integrated into Epic in order to enable providers nationwide to submit prior authorizations directly into their EHR workflows.
