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Your Guide for UM Transformation Without Legacy Tech

Stop struggling with outdated portal-only solutions that frustrate providers and delay care.

Legacy, portal-only utilization management solutions create more headaches than they solve. Bolted on innovation for one-off use-cases. Error-prone questionnaires. Faxes piling up. Providers calling constantly. It's time for a better approach that works for everyone involved.

Cohere’s AI-powered clinical intelligence platform is a next-gen solution to empower your provider network and engage them in prior authorization workflows that work. Get members faster access to care,  cut costs, and achieve exceptional provider satisfaction.

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Understanding the Limitations of Basic Portals & Basic AI

Many prior auth automation vendors face limitations in extracting meaningful clinical insights from unstructured data and supporting clinical team efficiency. These constraints result in incremental improvements rather than true utilization management optimization, leading to challenges.

Imagine a better way. With Cohere, you can overcome these obstacles and transform your utilization management process.

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Higher than Expected Administrative Costs

Higher than expected administrative costs eat into limited clinical resources, diverting focus from high-stakes reviews for patient care.
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Provider Frustration and Care Delays

Provider frustration and care delays from unnecessary back-and-forth and cumbersome workflows.
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Inefficiencies

Inefficiencies in decision-making and policy management drive higher medical spend.

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 Proven results, not empty promises. 

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Faster, More Accurate Decisions

70% Reduction in Care Delays - Instant approvals and workflow transparency to ensure patients get the right care on time.
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Medical Expense Savings

15% Incremental Medical Expense Savings generated by optimizing site-of-service decisions and guiding providers toward cost-effective care paths.
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Provider Satisfaction

93% Provider Satisfaction achieved, outperforming traditional vendors by reducing back-and-forth exchanges by 95%.
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Automation

Automate up to 90% of prior authorization requests with greater control, based on your unique guidelines and rules.
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How Cohere Makes Prior Authorization Seamless

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Clinical-Grade AI

Trained by clinicians, Cohere’s AI processes unstructured data and surfaces insights for accurate, evidence-backed decision-making.
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Policy Digitization Expertise

Support CMS 0057-F compliance with fully digitized medical policies to enable seamless prior authorization workflows.

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Real-Time Transparency

Deliver instant approvals and give providers full visibility into requests to streamline care delivery.

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Customizable Configurations

Unlike generic platforms, Cohere adapts to your unique policies, seamlessly integrating with your existing systems for maximum flexibility.
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Proven Interoperability

More live EHR connections than any other vendor... 240 unique facilities submitting to Cohere via EHRs.

Happy Providers, Better Outcomes

Your providers deserve tools that empower them to focus on delivering better care. Cohere’s platform minimizes administrative complexity, allowing providers to reclaim 8 hours per week and focus on patients. With Cohere, you can achieve 93% provider satisfaction and reduce back-and-forth by 95%, improving relationships and operational efficiency. That’s why providers overwhelmingly prefer Cohere over traditional solutions.

Why providers Love Cohere Health

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93% provider satisfaction with Cohere
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95% reduction in back-and-forth with Cohere
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  • Real-time visibility into patient data.

  • Transparent approvals and faster operations.

  • Higher-quality collaboration with fewer manual processes.

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8 hours per week reclaimed for providers to focus on patients
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How Cohere Outshines Traditional Vendors

Stop relying on basic, one-size-fits-all solutions that force your team to compromise. Cohere outpaces other platforms by delivering measurable results where it counts. 

Traditional Portals
✗ Unreliable clinical questionnaires with over 30% yielding inaccurate responses, often completed by non-clinical staff

✗ Limited to structured data without the ability to reason over unstructured clinical documentation

✗ Digital-only channels with fax follow-up burden falling on your team

✗ Only "recommends" approvals without true automation capabilities, still requiring manual review

✗ No policy digitization support or ability to adjust based on your specific UM approach



Cohere’s Clinical Intelligence Platform
✔ Clinical-grade AI that's 30% more accurate than other AI solutions with models precisely aligned to your goals

✔ Longitudinal patient records that capture specifics of conditions where most LLMs struggle with severity and anatomy

✔ Comprehensive channel support - direct EMR integration, portal, phone, and automated fax ingestion

✔ Up to 90% auto-approval rates with greater control based on your unique guidelines and rules

✔ 93% provider satisfaction with in-workflow policy transparency and clear guidance

✔Fully compliant, integrated CMS 0057-F solution

Take the Next Step Toward a New Legacy Defined by Collaboration and Intelligence

Cohere is more than a platform, it’s a partner in transforming prior authorization processes for better health outcomes, fewer delays, and massive cost savings. 

Don’t settle for basic AI or outdated portals. It’s time to unlock the future of utilization management with Cohere. 

 

 

See Cohere in Action!