Advance Notification Requests (Humana Only)
Advance Notification Requests (Humana Only)
What's Changing?
Advance notification is an alternative to the prior authorization process that does not require approval, so there is no delay in patient care. Submit the details and get your confirmation code instantly.
What you need to know:
An advance notification request requires no approval. This means no delay in patient care or scheduling. Once you submit, you will get instant confirmation and can move forward with patient care.
With advance notification, your submission is recorded, but does not require approval.
The advance notification process is currently offered to qualifying providers and procedures. (Humana only)
Including attachments is optional.
See the details below to learn more about how the advance notification process works.
When will I see Advance Notification?
When requesting a prior authorization in the Cohere portal, the portal may alert you that one or more of the codes in your request have qualified for advance notification instead of prior authorization.
If you receive this message, submitting an advance notification is highly recommended. An advance notification request will require no approval. This means no delay in patient care or scheduling. Once you submit, you will get instant confirmation and can move forward with patient care.
Recommended: To continue with advance notification, you can submit the details and get your confirmation code instantly.
Not recommended: To continue to submit the code for prior authorization review, please submit via fax at 800-266-3022
In cases of mixed code submissions (i.e., when only some of the codes qualify for advance notification), you will be asked to submit your entire request as a prior authorization.
How can I request an Advance Notification?
At the top of the patient summary page, you will have the option to move between viewing authorizations and advance notifications.
To start an advance notification request, click "Star request" just like you would to start a prior authorization request. If your request qualifies for an advance notification, the system will let you know.
Please note: including attachments will not be required for advance notice requests. However, documentation will help Cohere confirm that this provider continues to be eligible for the advance notification program. Advance notifications are recorded as informational only and do not require approval.
Where can I find an advance notification request?
From the dashboard, you can now filter by the “type” of request, which allows you to select and view all advance notification requests. You can also use the search bar to search for a specific patient name, member ID, tracking ID or authorization ID. All advance notification tracking IDs begin with “AN”. When searching on the dashboard, be sure to enter the full tracking ID, including the “AN” prefix.
From the patient summary, you can select “Advance notifications” at the top of the page to view all advance notification requests for that patient.
Non-PAL Code Improvements
Non-PAL Code Improvements
An exciting new feature is now live in the portal for select health plans to improve prior-authorization accuracy and efficiency! These changes are applicable when submitting codes that are either:
Not on the Prior Authorization List (PAL) but require an authorization due to CRD conditions OR
Normally do not require prior authorization (referred to as exception codes)
What's changing and why?
Previously, when submitting requests for non-PAL exception codes, submitters were not able to indicate the reason for submission.
The new process includes an in-portal pop-up guiding you to select a qualifying reason for non-PAL exception codes (reasons may vary by payer) and an optional free-text explanation. Additionally, you'll be able to cancel the request altogether, when applicable. The reason and explanation you provide will be available for clinical reviewers to reference during the decisioning process, improving decision efficiency and accuracy.
Who does this change affect?
Applicable Health Plans: Currently, this feature is available for Geisinger Health Plan, but will expand to Medical Mutual and Blue Cross Blue Shield of South Carolina health plans in the future. Check back on this page for updates!
Submitters: Improved clarity and guidance during non-PAL exception code submission to ensure compliance and reduce work.
Reviewers: Enhanced visibility into PAL/non-PAL status and submission reasons for exception codes to streamline reviews.
Process Changes:
Previous process: Enter authorization details → Cohere portal indicates which codes require authorization → Ability to download PDF confirmation for codes that do not require authorization → Continue with submission
New process: Enter authorization details → Cohere portal indicates which codes require authorization → Ability to download PDF confirmation for codes that do not require authorization → Ability to indicate qualifying reason to include code in submission, including optional free text box → Continue with submission
What should I expect to see in the portal?
You will see the option to indicate a reason for including a non-PAL code.
Screenshots of the updated process:
Withdrawn/Void Reason Display Enhancement
Withdrawn/Void Reason Display Enhancement
This new enhancement was put in place to increase transparency and improve user experience.
What's changing?
This enhancement will allow users to see the specific reason why a request was withdrawn or voided. Prior to this release, users did not have visibility into why a request was withdrawn or voided, leading to confusion and additional inquiries.
Who does this change affect?
ALL users who interact with withdrawn or voided requests will be impacted by this change.
Process Changes:
Previous process: Previously, users were only able to see the status of withdrawn and voided requests, no details.
New process: Now, users will be able to see both the status of withdrawn and voided requests, as well as details of why the request was withdrawn or voided.
What should I expect to see in the portal?
After an authorization has been withdrawn or voided, the portal will reflect the new status and display a withdrawal/void reason.
Screenshots of the updated process:
Procedure Code Attributes
Procedure Code Attributes
This new enhancement was put in place to increase the decision accuracy and to increase auto-approvals when appropriate.
What’s changing?
This portal enhancement will allow users to indicate specifics for certain codes in the Cohere portal. Some procedure codes are generic and do not have specific descriptions, making it difficult for clinical reviewers to decision requests without requesting additional information from the submitter. This enhancement will eliminate the need to do so, collecting needed information directly from the portal.
Who does this change affect?
Applicable Health Plans: This feature will be rolled out on a payer-by-payer basis. Currently, it's available for Medical Mutual, BCBST, Humana, Avera and HealthPartners. We also plan to release this feature for Geisinger in the future; check back for updates on this page over the next several weeks!
Submitters: This enhancement will streamline the submission process by allowing submitters to indicate request specifics directly within the portal, integrating seamlessly into the current submission process. To avoid delays, please ensure the selected attribute matches up with what is in the uploaded clinical attachments.
Reviewers: This enhancement will streamline reviews by eliminating the need to search for specific indications within clinical attachments. However, the selected attributes should match up with what is included in uploaded attachments.
This will affect mainly the following request types:
Musculoskeletal (MSK) procedures where the side or area of the body must be clearly indicated
Diagnostic imaging (DI) procedures where the area of the body being imaged must be clearly indicated
Other generic codes that have a non-specific description
Process Changes:
Previous process: Previously, users were not able to indicate specificities for codes directly within the portal. Instead, they were expected to include these details in the clinical attachments uploaded with their requests; this process was inefficient for both submitters and clinical reviewers.
New process: Now, users will be able to indicate specifics for the selected procedure codes directly within the Cohere portal.
You will see three different types of attributes:
Single-select
When requesting a bilateral procedure, you must request 2 units.
Multi-select
There is no limit to what can be selected, but 1 unit must be requested per selected attribute.
e.g., For diagnostic imaging, you should request 1 unit per body part requested.
Free-text explanation
You will be asked to explain why a code is needed. In the screenshot example below, the provided procedure code is an unlisted code, and Cohere needs more details on why the code requested is associated with the requested procedure and what the procedure actually entails.
What should I expect to see in the portal?
You will see the option to indicate these details on the “Authorization check results” page within the Cohere portal submission workflow. Again, you will see a single select, multi select, or free-text explanation, depending on the procedure code. Remember, these will only appear for certain codes, not all.
Concurrent Review Improvements
Concurrent Review Improvements
Prior to January 1, 2026, to improve clarity, you will no longer see “pending days” on an authorization after initial review. This change will help ensure that each submitted request shows only the information that applies to that current authorization.
Who does this affect?
This change will affect Geisinger (GHP), Oak Street Health (OSH)-Aetna and Oak Street Health (OSH)-Humana providers.
Please review the payer specific details below.
For Geisinger (GHP) submitters:
What you currently see: | What should you expect to see? |
Inpatient continuations are consolidated rather than split into multiple separate requests. The timeline visually indicates:
| Your inpatient authorization will no longer display as pending, it will show as approved. To update dates or make other necessary changes to the authorization, you can start a continuation directly from the patient summary. |
For Oak Street Health (OSH) -Aetna and Oak Street Health (OSH) - Humana submitters
What you currently see: | What should you expect to see? |
Your inpatient authorization will no longer display as pending, it will show as approved. To update dates or make other necessary changes to the authorization, you can start a continuation directly from the patient summary. |
For all GHP, OSH-Aetna & OSH-Humana submitters:
If you click “edit” on an approved authorization to add documentation, the portal will display the following guidance to help you choose the correct action. Please select the option that best matches what you need to update.
New Portal Feature: Optional Health Plan Selector in Patient Search Box
New Portal Feature: Optional Health Plan Selector in Patient Search Box
What's changing?
Beginning December 17, 2025, to support a more accurate and secure patient search experience, a new optional Health Plan selector will be available in the portal when searching for a patient. This update allows you to search for a patient using the health plan, in addition to the member ID and date of birth that continue to be required.