Revolutionizing Healthcare Prior Authorization: Humana and Cohere Health Partner to Expand Services Nationwide

Humana, a leading health insurer, has announced an expansion of its partnership with Cohere Health. The latest addition to the program includes diagnostic imaging and sleep solutions as part of the services offered to Humana’s members and providers.

Initially launched in 12 states, the pilot program for musculoskeletal services has now expanded to cover all 50 states after showing promise. Humana has rolled out Cohere’s offerings nationwide, adding cardiovascular and surgical services to the program last year. The partnership with Cohere Health aims to improve the prior authorization process for musculoskeletal issues by utilizing predictive technology and clinical intelligence.

The Cohere Unify Platform utilizes AI to accelerate the prior authorization process by providing suggestions to providers before submitting requests, which helps reduce denial rates from insurers. CEO of Cohere Health, Siva Namasivayam, expressed pleasure in Humana utilizing their diagnostic imaging and sleep solutions, enhancing the ongoing partnership.

Cohere’s solutions are based on evidence-based guidelines from medical societies and advanced technology to align patient services within care pathways to enable faster diagnoses. In February, Cohere secured $50 million in equity funding, bringing their total raise to $106 million. The company has rapidly grown since its launch, securing funding and partnerships along the way. Their partnership with Oracle aims to develop genAI services to automate business processes by combining Oracle’s cloud infrastructure with Cohere’s technology. Recently, Cohere also announced integration into Epic, allowing providers to submit prior authorizations directly into their EHR workflows.