Coming Soon: Submit Authorizations for Essence Healthcare
We're excited to share that providers will soon be able to submit authorization requests for Essence Healthcare through the Cohere portal. Please watch for upcoming communications regarding the official date to begin using Cohere for Essence Healthcare authorizations.
Whom and what services does this affect?
Line of Business: Medicare Advantage
Clinical Scope:
Services Submitted Through Cohere
Medical Prior Authorizations
HMO Member Referrals
Part B drugs furnished through the provider (non-oncology)
Non-preferred blood glucose monitors and test strips
Services not Submitted Through Cohere
Behavioral Health Prior Authorizations: Continue submitting to Mercy Behavioral Health via Phone/Fax
Part D Pharmacy Requests: Continue submitting to Express Scripts
Part B Oncology Drugs: Continue Submitting to Health Help
Concurrent Review Activities (Acute Inpatient Admissions & Continued Stay for Inpatient LTAC, Rehab, & SNF): Continue submitting to Essence using the EHI Portal or UM Phone/Fax
Prior Authorization List (PAL)
Prior authorizations must be submitted through the Cohere Health portal for any of the procedure codes listed in the table linked below. For the most up to date PAL, please reference the Essence Provider Portal. Note: Providers should continue to follow existing processes for services not included in Cohere.