Cohere To Take Over All MSK, Therapy Prior Authorization for Humana

Humana's decision to rely solely on Cohere beginning Jan. 1, 2022, comes after a 12-state program rolled out this year.

Commercial insurance giant Humana will be moving to a single vendor for musculoskeletal and therapy prior authorizations beginning Jan. 1, 2022, a decision that the insurer says is based in part on the success of the system in 12 states that were assigned to Cohere at the beginning of 2021.

According to an information sheet from Cohere, the prior authorization system will be used for most Humana commercial and Medicare members, where the company will be Humana's vendor for prior approval of CPT codes associated with musculoskeletal care and therapy. Services covered by the system include physical therapy, occupational therapy, speech therapy, orthopedic surgeries, and pain management services.

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