Inpatient behavioral health prior authorization through Cohere begins June 24
Since the beginning of 2023, Cohere Health has helped manage outpatient service prior authorization requests for Geisinger Health Plan members. In March, we expanded our partnership with Cohere to include submission of most inpatient prior authorization requests. Now, inpatient behavioral health prior authorization requests will be available through Cohere as of Monday, June 24.
Beginning June 24 for inpatient behavioral health services:
- You’ll be able to request prior authorization for inpatient behavioral health services through Cohere for all your Geisinger Health Plan patients.
- You’ll benefit from a streamlined and collaborative online authorization experience — better than phone and fax!
- Geisinger Health Plan Medical Management will still review requests and retain ultimate authority over medical necessity determinations.
- Check our prior authorization list frequently so you always know which services require authorization submission through Cohere.
What you should do to prepare
- Reduce your administrative burden — register with Cohere and become familiar with Cohere’s online authorization portal right away.
- Expect Cohere to reach out to you directly — keep an eye out and be sure your staff is alerted to messages from Cohere.
- Know that “prior authorization” may often be referred to as “preauthorization” by Cohere.
- Take advantage of learning opportunities like Geisinger Health Plan townhalls, Cohere webinars and Cohere’s user-friendly online learning center.
Attend an upcoming townhall
We’re hosting virtual townhalls for healthcare practitioners and office staff. Geisinger and Cohere Health representatives will discuss prior authorization requirements and how to get started with Cohere Health’s streamlined and collaborative online authorization experience.
Have your questions answered at an upcoming virtual townhall. Join the townhalls through NaviNet or ask your Geisinger Health Plan account manager for links to the meetings.
Learn more
Save time and be ready to serve your Geisinger Health Plan patients this summer.
- Look for upcoming Geisinger Health Plan and Cohere virtual townhalls through Microsoft Teams.
- Attend Cohere training webinars, including one-on-one office hours to walk you through registration.
- Visit the Cohere Learning Center to learn at your own pace and view detailed user guides. You’ll need to have a Cohere account to access the learning center.
How Cohere makes prior authorization easy
Cohere’s online portal lets you review and approve authorization requests quickly so your patients can get the care they need. A combination of technology and a team of nurses and doctors makes sure care is medically appropriate and meets clinical guidelines.
Here’s what happens when you submit an authorization request online through Cohere:
- Cohere’s real-time consultative request process efficiently guides you through each step.
- Your request is reviewed immediately. If all the required information is there and meets all applicable guidelines, you will see the authorization number populate in the portal upon approval.
Checking authorization status is easy, too. When a request has received a final determination (approved, partially approved, denied), Cohere will notify the submitter via email.
Cohere offers useful options for status checks either through the online portal or an authorization check page for those without portal access. Using the online portal is the best way to manage authorization requests. However, you’ll still have offline options for obtaining approval so patient care isn’t hindered if you can’t connect to the web.
Register today
Visit Cohere online and register before Monday, June 24. Questions? Connect with a Cohere representative through the in-app chat directly on the registration page.About Cohere
Cohere Health is a digital intelligence company that’s transforming utilization management by aligning physicians and health plans on evidence-based care paths for the patient's entire care journey. By integrating these care paths into the prior authorization submission process, Cohere's digital UM collaboration platform reduces denial rates and medical expenses while improving patient outcomes. Cohere serves over 5 million members nationally, in every community around the county, in every practice setting. Cohere uses technology to auto-approve clinically optimal care for members.
Contact us
Your Geisinger Health Plan account manager and Cohere representatives are here to help. Contact your account manager at 800-876-5357 or ghpaccountmngt@geisinger.edu.
