Overview
This article houses some of our most frequently asked questions and their answers.
How do I register for a Cohere account?
How do I register for a Cohere account?
To register for a Cohere account, go to coherehealth.com/provider/resources.
Click on the pink “Start my registration” button.
You will then enter your practice TIN and email address. You will then continue through the rest of the registration process.
If you need any help or guidance, we highly recommend utilizing our step by step guide to help you through the registration process.
This guide is also linked on both of the aforementioned pages.
How do I access the Cohere portal? How do I submit with Cohere?
How do I access the Cohere portal? How do I submit with Cohere?
You can get to the Cohere portal by going to login.coherehealth.com.
Need information on how to start submitting? We offer training webinars that you can attend.
Do you use a single sign on method to access the Cohere portal? Find more details about the SSO process here.
How long does it take to get an approval?
How long does it take to get an approval?
The time to approval will vary depending on the specific details of the request.
In some cases, you may be eligible for an automatic approval for your authorization. In other cases, your request may pend for either determination of medical necessity or due to missing information.
The best way to reduce delays is to include all relevant clinical documentation within your request.
Are the diagnosis codes listed on the authorization the only diagnoses that are covered by the authorization?
Are the diagnosis codes listed on the authorization the only diagnoses that are covered by the authorization?
Yes, the diagnosis codes listed are the ones included in your authorization. You can add additional diagnoses when submitting a request if needed.
How can I update my contact information in the Cohere portal?
How can I update my contact information in the Cohere portal?
If you notice that the information we have listed in the Cohere portal is incorrect, please follow the steps below to make updates. Neither admins nor Cohere can change a user’s email address. To update this, a user must be removed and then re-added.
Non-Admin Users
If you are not an admin at your organization and need to update your contact information, you can do this directly from the portal! Start by clicking "My Account", then click your name to open your account details. Once your information is open, you are able to add or edit the details. We encourage you to add a fax number and phone number if one isn’t already listed.
If you feel you should be an admin for your organization, we encourage you to reach out to the admin (if possible) to request changes.
Admins
Admins can make changes to all other user’s information, except email. Here’s how:
Navigate to the organization’s management page by selecting “My account” and then pressing “Management”.
Find the intended user.
Press the 3 dots to the right of the user and select “Edit user”.
My new authorization request says "pending review," but it shows an authorization number. Is it actually approved?
My new authorization request says "pending review," but it shows an authorization number. Is it actually approved?
No, in some cases, you may receive an authorization number right away while it is pending. This authorization number will, however, remain the same if and when your authorization is approved.
Example of an auth with an authorization number while pending for review:
I was told to submit my requests through Cohere. Why does my request say it is being reviewed by somebody else?
I was told to submit my requests through Cohere. Why does my request say it is being reviewed by somebody else?
To streamline and improve your workflow, you can submit many services through Cohere, even if they are reviewed by a clinical team outside of Cohere. In some cases, you may see this reflected in the “pending review” message in the Cohere portal.
Example of pending message:
Can we enter grouper codes that encompass multiple procedure codes with our authorizations?
Can we enter grouper codes that encompass multiple procedure codes with our authorizations?
A grouper code is a code identifying the general category of payment adjustment.
Cohere does not authorize these types of codes, we authorize specific services. To learn more about the specific codes that are within Cohere’s scope, please reference the prior authorization lists in our Payer Information Center.
What happens if we disagree with your decision? Can we appeal?
What happens if we disagree with your decision? Can we appeal?
If your request is denied, you will receive a notification via mail and phone. If you disagree with the decision, you will need to request a reconsideration and/or appeal with the relevant health plan.
Visit this article to learn more about the appeal process for each payer.
Is there a limit to how many procedure codes and diagnosis codes I can submit with my request?
Is there a limit to how many procedure codes and diagnosis codes I can submit with my request?
Procedure codes:
You can submit up to TEN (10) procedure codes in one authorization request. If you need to submit more than 10, we suggest submitting those additional codes in another request.
Diagnosis codes:
You can enter ONE (1) primary diagnosis and up to NINE (9) secondary diagnosis codes.
Does Cohere handle claims payments?
Does Cohere handle claims payments?
Cohere does not handle claims payments. Any questions about claims payments should be directed to the appropriate payer.
Does each service get its own authorization number?
Does each service get its own authorization number?
Yes, each service (regardless of the number of services you submit) is processed individually, has an individual decision, and receives its own authorization number.
Can I submit an authorization after a service has occurred?
Can I submit an authorization after a service has occurred?
This would be considered a retro authorization. You are able to submit these types of requests as you normally would in the Cohere portal. Simply enter the expected start date in the past, on the date that the services started. Our guidance is to submit the authorization request as soon as possible after the service has occurred. Please ensure that you are following payer policy, as not all payers allow for these types of authorizations. Check the respective payer’s website for more details.
Why do I have to select a reason for declining a nudge?
Why do I have to select a reason for declining a nudge?
Cohere is committed to continuously improving the experience within our portal. For some in-portal nudges, you may see a dropdown menu prompting you to select a predefined reason for declining the nudge. This feature allows you to give your rationale or feedback on why you have chosen to decline the nudge and either discard or continue the request; this feature was developed to obtain direct feedback from you, the user, on the effectiveness of our in-portal nudges, so that we can make updates and improvements accordingly.