Cohere Health Partners with Microsoft to Advance Prior Authorization with Ambient Listening

Prior authorization companies are moving toward ambient listening, while ambient listening companies are expanding toward prior authorization — a trend highlighted by another partnership connecting the two spaces.

On Thursday, Cohere Health, a clinical intelligence company that works to improve relationships between payers and providers, announced a collaboration with Microsoft Dragon Copilot to advance prior authorization. This comes shortly after Highmark Health and Abridge launched a similar partnership aimed at streamlining prior authorization through ambient AI.

Through the Cohere and Microsoft collaboration, providers using Dragon Copilot’s ambient listening technology during patient visits will be able to immediately submit prior authorization requests and receive feedback from health plans.

Ambient listening technology will enable Cohere Health AI agents to collect and analyze relevant patient data and medical history to support these prior authorization requests. Cohere Health will also notify the physician of the requirements for prior authorization to be approved.

“The doctor has the possibility of asking the patient: [for example]the type of pain they’re experiencing,” Gus Weber, chief digital and technology officer at Cohere Health, said in an interview. “That may be a prerequisite for prior authorization approval. This really reduces friction for the supplier. It also allows the patient to get the care they need much more quickly. So this is a great opportunity for us to really get into the moment of truth with the patient and the doctor.

The Highmark Health/Abridge collaboration, announced in August, has similar goals: reducing friction between payers and providers. Organizations are developing technology that will identify when prior authorization is needed during patient visits, automatically generate a request, and prompt the clinician to fill in missing information before the patient leaves the room.

This differs from the Cohere/Microsoft collaboration, however, because Microsoft Dragon Copilot is building an ecosystem of third parties that customers can choose to integrate into their ambient listening capabilities, such as Cohere, Atropos Health, and Ensemble. Cohere was drawn to work with Microsoft rather than Abridge and other ambient companies because of this ecosystem, according to Weber.

By partnering with Cohere, Microsoft ultimately aims to ease the administrative burden on clinicians, said Peter Durlach, CVP and director of strategy for healthcare and life sciences at Microsoft. He noted that doctors spend a significant portion of their time on administrative tasks, with prior authorization being one of the main contributors.

“By allowing Cohere to integrate its AI solution into our AI clinical assistant, we are providing clinicians and other staff with transparency and guidance at the point of care, helping them achieve clinical approvals more quickly and with confidence,” he said in an email. “Our goal is simple: to give clinicians time back in their day so they can focus on what matters most to them, which is caring for patients while supporting the financial integrity of the practice.”

Several insurance companies are also working to improve the pre-authorization process. In June, more than 50 health plans made a series of commitments to obtain prior authorization, such as UnitedHealthcare, Aetna and Cigna. Commitments include standardizing electronic prior authorization and expanding real-time responses.

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