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Prior authorization requests for inpatient behavioral health services are excluded and will not be available through Cohere at this time.

Since the beginning of 2023, Cohere Health has helped manage outpatient service prior authorization requests for Geisinger Health Plan members. We’re now expanding our partnership with Cohere to include submission of inpatient prior authorization requests as of Monday, April 29.

Beginning Monday, April 29, for inpatient services:

  • You’ll be able to request prior authorization for all inpatient services (except inpatient behavioral health services) through Cohere for all your Geisinger Health Plan patients.
  • Inpatient behavioral health services are excluded for now. Continue to request authorization for inpatient behavioral health services directly from Geisinger Health Plan medical management as normal until further notice.
  • You’ll benefit from a streamlined and collaborative online authorization experience — better than phone and fax — that offers evidence-based care suggestions, faster approval and even instant authorization in some cases!
  • Geisinger Health Plan Medical Management will still review requests and retain ultimate authority over medical necessity determinations.
  • Check our prior authorization list frequently so you always know which services require authorization submission through Cohere.

How to prepare

  • Reduce your administrative burden — register with Cohere and become familiar with Cohere’s online authorization portal.
  • Expect Cohere to reach out to you directly — keep an eye out and be sure your staff is alerted to messages from Cohere.
  • Know that “prior authorization” may often be referred to as “preauthorization” by Cohere.
  • Take advantage of learning opportunities like Geisinger Health Plan townhalls, Cohere webinars and Cohere’s user-friendly online learning center.

Attend an upcoming townhall

We’re hosting virtual townhalls for healthcare practitioners and office staff. Geisinger and Cohere Health representatives will discuss prior authorization requirements and how to get started with Cohere Health’s streamlined and collaborative online authorization experience.

Have your questions answered at an upcoming virtual townhall. Join the townhalls through NaviNet or ask your Geisinger Health Plan Account Manager for links to the meetings.

Learn more

Save time and be ready to serve your Geisinger Health Plan patients in 2024.

  • Look for upcoming Geisinger Health Plan and Cohere virtual townhalls through MS Teams.
  • Attend Cohere training webinars, including one-on-one office hours to walk you through registration.
  • Visit the Cohere Learning Center to learn at your own pace and view detailed user guides. You’ll need to have a Cohere account to access the learning center.

How Cohere makes prior authorization easy

Cohere’s online portal is an easy way to get authorization requests reviewed and approved quickly so your patients can get the care they need. A combination of technology and a team of nurses and doctors makes sure care is medically appropriate and meets clinical guidelines.

Here’s what happens when you submit an authorization request online through Cohere:

  1. Cohere’s real-time consultative request process guides you through each step, providing patient-specific suggestions that can expedite approval.
  2. Your request is reviewed immediately. If all required information is there and meets all applicable guidelines, your request may be eligible for auto-approval. Upon approval, the authorization number populates in the portal.
  3. If Cohere’s technology can’t auto-approve, Geisinger Health Plan Medical Management will review your request.

Checking authorization status is easy, too. When your request has received a final determination (approved, partially approved or denied), you’ll be emailed this information.

Cohere offers useful options for status checks either through the online portal or an authorization check page for those without portal access. Using the online portal is the best way to manage authorization requests. However, you’ll also have offline options for obtaining approval so patient care is not hindered if you have connectivity issues.

Register today

Visit Cohere online and register with Cohere today! You’ll need to be registered before April 29. Have questions about registration? Connect with a Cohere representative through the in-app chat on the registration page.

About Cohere

Cohere Health is a digital intelligence company that’s transforming utilization management by aligning physicians and health plans on evidence-based care paths for the patient's entire care journey. By integrating these care paths into the prior authorization submission process, Cohere's digital UM collaboration platform reduces denial rates and medical expenses while improving patient outcomes. Cohere serves over 5 million members nationally, in every community around the county, in every practice setting. Cohere uses technology to auto-approve clinically optimal care for members.

Contact us

Your Geisinger Health Plan account manager and Cohere representatives are here to help. Contact your account manager at 800-876-5357 or        



This Operations Bulletin and the information contained herein amend the GHP Participating Provider Guide, effective April 29, 2024. 

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