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Solutions
Description
Compatibility Level
Clients
Product Capabilities
Use cases
EHR integrations
Client types
Awards
Differentiators
Keywords
Media
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 Authorizations
Prior Authorizations

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Categories

Solutions

Description

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.

Product Description:

Improve patient access by accelerating time to care while reducing FTE resource spend on manual, repetitive tasks involved with obtaining prior authorizations.

About Adonis:

Adonis fosters unparalleled revenue outcomes that improve efficiency, reduce costs, and increase revenue. Our partnerships are forged in the commitment to long-term financial success. Whether you're a provider with an internal billing team or you outsource your RCM operation, we're prepared to meet you where you are to improve your billing and collections outcomes.

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

Adonis’ Automated Prior Authorizations integrates with providers’ appointment systems to automatically review all upcoming appointments and identify those that will require prior authorization. Adonis uses a combination of machine learning and expert input to keep payer rules up to date, ensuring that all relevant appointments receive a prior authorization.

Adonis leverages machine learning and expert input to continually update its knowledge base. Adonis leverages AI to automatically identify and store payer rule updates.

Adonis’ prior authorization specialists use Adonis’ proprietary work list and form completion tools to more accurately and efficiently submit requests to the relevant payers. The speed and precision enabled by these automations lead to faster and higher rates of approvals.

Adonis’ prior authorization specialists use Adonis’ proprietary work list and form completion tools to more accurately and efficiently submit requests to the relevant payers. The speed and precision enabled by these automations lead to faster and higher rates of approvals.

Adonis’ prior authorization work list and form completion tooling allow for flexible document attachments, ensuring that all necessary information for receiving approval can be easily found and submitted.

Once Adonis identifies that prior authorization is required, the upcoming visit will enter our team’s work list. From there, our team members will prioritize prior authorizations based on service date.

The Prior Authorization Status Dashboard enables status tracking for all prior authorization requests.

Use Cases

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
Description:

Adonis’ Automated Prior Authorizations identifies scheduled patient visits that require authorizations by utilizing existing stored payer rules. Your staff is notified when authorizations are complete, denied, or require additional information not readily available within your system. All authorization data is pushed back to your system of record.

Pediatric use cases:

Adonis' Automated Prior Authorization is applicable across many specialty areas, including pediatrics;

Users:

Front-desk staff, Revenue Cycle Management Team

EHR Integrations

Integrations:

Other

EMR Integration & Relevant Hardware:

Recommended, but not required

EMRs Supported:

Epic

Hardware Compatibility:

None provided

Integrations:

Acute care EMR, Ambulatory EMR, Ancillary EMR

EMR Integration & Relevant Hardware:

Recommended, but not required

EMRs Supported:

NextGen, athena, eClinicalWorks

Hardware Compatibility:

Desktop, Mobile / Tablet (web optimized), Mobile / Tablet (native app)

Client Types

None provided

Awards

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Differentiators

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
Differentiators vs EHR Functionality:
  • Fully Outsourced - Adonis handles all of the Prior Authorization workflows for your team and pushes the data back to the necessary systems
  • Highly automated - Prior Authorizations are performed behind the scenes with minimal intervention from staff
  • Machine Learning Backed Automations - Our machine learning models are trained on your Prior Authorization data, leading to efficiency gains and greater automations over time
Differentiators vs Competitors:
  • Adonis automates the bulk of authorization tasks, allowing your staff to prioritize high-value work and complex follow-ups.
  • Adonis maintains up-to-date payer rules, eliminating the need for staff members to regularly visit payer sites or commit guidelines to memory.
  • Adonis leverages machine learning to deliver exponentially increasing efficiency gains over time.

Keywords

Images

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Videos

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Video: Cohere Unify

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Downloads

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Company Details

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