Overview
This article houses some of our most frequently asked questions and their answers for Avera specifically.
How do I register for a Cohere account?
To register for a Cohere account, go to coherehealth.com/provider/register.
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?
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.
Click here if you're looking for information about the single sign on process.
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.
What do I do if my request pends for review?
If your request pends for review, the submitter will be contacted if additional information or documentation is needed to decision the request. After a decision has been made, the submitter will receive an automated email notification.
In some cases, a pended authorization will result in the need for a peer to peer consultation. If this is the case, Cohere will contact the submitter to schedule this call with a member of your clinical staff.
When do I have to start using Cohere? What lines of business and codes are applicable to this change?
Avera and Cohere are scheduled to go live on September 16, 2024.
Find Avera’s Prior Authorization List (PAL) here.
How do I enter member IDs in the Cohere Portal?
When submitting authorizations in the Cohere portal, you are asked to enter the member’s health plan member ID and date of birth. On Avera insurance cards, you will see a twelve digit member number. Cohere and Avera have worked together to make it so that you can enter the member ID in two different ways:
You can enter the full, twelve digit number as it is found on the insurance card. OR
You can also enter it in with a hyphen between the tenth (10) and final two numbers. For example, if the member ID number is listed as 100000000001, you can enter 1000000000-01 in the Cohere portal.
If you ever have any issues finding a patient within the Cohere portal, please be sure you are entering their information in one of the two ways listed above. If you still cannot find them, please reach out to Cohere.