Cohere Health

Nicole Saidai

View the criteria that is used to decision your authorization requests. NOTE: if you submit authorizations for multiple payers, the review criteria requirements may differ by payer.

Review Criteria

Frequently Asked Questions

Differences Among Payers

Submitting for multiple payers?

Cohere Guidelines - All Specialties

Cohere Guidelines

National Care Guidelines

Avera Health Plan: Commercial Guidelines

Avera Health Plan

Geisinger Health Plan Cardiovascular & Musculoskeletal Guidelines

Review Criteria: Electrical and Electromagnetic Stimulation to aid wound healing

Review Criteria: Comparative Genomic Hybridization for Evaluation of Developmental Delay

Review Criteria: Intercostal Nerve Block

Review Criteria: Non-Wearable Automatic External Defibrillator

Review Criteria: Acupuncture

Review Criteria: Tumor Treatment Field Therapy

Review Criteria: Breast Reduction

Review Criteria: Mechanical In-Exsufflation Device

Review Criteria: Physical, Occupational, or Speech Therapy

Review Criteria: Manual Wheelchair

Review Criteria: Prosthetics

Review Criteria: Nutritional Supplements

Review Criteria: Whole Exome Sequencing

Review Criteria: Vision Therapy/Orthoptics

Review Criteria: Varicose Vein Treatments

Review Criteria: Vagal Nerve Stimulation

Review Criteria: Suprascapular & Sympathetic Nerve Block

Review Criteria: Shift Care

Review Criteria: Speech Generating Devices

Review Criteria: Lung Volume Reduction Surgery

Review Criteria: Gastric Electrical Stimulation

Review Criteria: Fetal Surgery

Review Criteria: Pulse Oximeter

Review Criteria: Rhinoplasty/ Septoplasty

Review Criteria: Genetic Susceptibility Cancer Panels

Review Criteria: Miscellaneous

Review Criteria: Dental Services

Review Criteria: Molecular Testing

Review Criteria: Transoral Incisionless Fundoplication

Review Criteria: Intrathecal Infusion Pump

Review Criteria: Neuromuscular Electrical Stimulation (NMES)

Review Criteria: Obesity Surgery

Review Criteria: Progressive Stretch Device

Review Criteria: Proton Beam Radiation

Review Criteria: High Frequency Chest Wall Oscillation Device

Review Criteria: Colorectal Cancer Genetic Testing

Review Criteria: Gender Dysphoria and Gender Confirmation Treatment

Review Criteria: Dorsal Column Stimulation

Review Criteria: Deep Brain Stimulation

Review Criteria: Blepharoplasty

Review Criteria: Ambulance Transport Service

Review Criteria: Orthotics & Orthopedic Footwear

Review Criteria: Home Health

Geisinger Health Plan

HealthPartners: Cohere Medicare Advantage & Commercial/Medicaid Policies

HealthPartners®

Humana Policies and Guidelines

Humana

Medical Mutual (MMO): Commercial & Medicare Advantage (MA) Guidelines

Medical Mutual (MMO)

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