How To Get an Approval with Cohere

Do you have questions about how to get approval through Cohere? The process is as simple as following these 3 steps:

      1. Submit requests via Cohere's online platform
      2. Follow our clinical guidelines for evidence-based care
      3. Upload clinical attachments

Click here to review the details of each of these steps to make sure you have all the necessary information to receive approvals. 

Step 1: Submit requests via Cohere's online platform

Using the platform will make you much more likely to receive an auto-approval than non-platform submission methods like fax or phone. Submitting requests online allows you to ensure you submit all the necessary information required for approval.

  1. To submit a request online, you will first need to log in by going to next.coherehealth.com and entering your username and password. If you are unsure if you have an account, please try signing in to the portal first, and then contact support at 1-833-283-0033.
  2. If you or others at your organization do not have an account, please complete the registration form here: coherehealth.com/register.

Step 2: Follow clinical guidelines for evidence-based care

Please review the payer's guidelines to understand what needs to be documented and submitted with your request to ensure you are meeting evidence-based care. This includes, but is not limited to, adding all service details (number of visits, site of service, performing provider, etc.) and answering clinical questions. Additional examples of clinical reasons that requests might pend for review include:

  • Ordering more than the recommended number of injections or physical therapy visits. To help you make a selection that will be approved more quickly, the recommended number will auto-fill in the “unit” or “number of visits” field.
  • Submitting an inpatient surgery request for a patient with no surgical risk factors. At Cohere, our goal is to ensure the optimal site of service for patients based on medical criteria and surgical risk factors. 

Clinical assessment questions are designed to capture key information about the patient's specific clinical situation based on the diagnosis and services requested for approval. Answering these clinical assessment questions increases our ability to issue an auto-approval, which ultimately saves you time.

Step 3: Upload clinical attachments

Including clinical documentation with every request will help expedite the review of your request. Without this information, our technology and the reviewers will be unable to process the request and will be required to reach out seeking this important information.

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Have more questions?
Submit a request