Humana (HUM) and Cohere Health Expand Prior Authorization Partnership

Cohere Health, a recognized leader in clinical intelligence and prior authorization automation, announced that Humana Inc. (NYSE: HUM) will expand its use of Cohere's prior authorization platform for diagnostic imaging and sleep services.

"Expanding our partnership with Cohere further supports our commitment to improving prior authorization for our members and providers," said Lisa Stephens, Senior Vice President of Clinical Operations at Humana. "Diagnostic imaging is often the start of a patient's journey, and we are confident our collaboration will further elevate our members' overall healthcare journey and streamline administrative tasks for our providers."

In January 2021, Cohere and Humana began a pilot program in 12 states to improve the prior authorization process for musculoskeletal (MSK) services. The program successfully reduced prior authorization approval turnaround times, increased provider satisfaction, and enhanced care delivery for MSK services, which resulted in an expansion across all 50 states in 2022. In January 2023, Cohere's solutions were deployed nationwide to include cardiovascular and surgical services.

"We're pleased Humana will be utilizing our diagnostic imaging and sleep solutions, further strengthening our strategic and ongoing partnership," said Siva Namasivayam, Chief Executive Officer of Cohere Health. "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."

Cohere's prior authorization platform helps providers and patients get to 'yes' more quickly. Cohere's unique blend of real-time analytics and deep, evidence-based clinical intelligence reduces prior authorization denial rates and leads to faster patient access to care.

Cohere processes 5.5 million prior authorizations annually, positively impacting more than 15 million health plan members and 420,000 healthcare providers nationwide.

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