CommercialPrior AuthHigh impact
New Cohere sleep management program aims to improve quality and reduce member cost
Geisinger Health Plan·Sleep Medicine, Pulmonology, Internal Medicine·Quality
Effective date
Feb 16, 2026
We identified it
Jul 29, 2026
Summary
Effective February 16, 2026, Geisinger Health Plan (GHP) now requires prior authorization through Cohere Health for all facility-based sleep studies. At-home sleep studies remain exempt from prior authorization. Billing teams must route all facility-based sleep study requests through the Cohere Health provider portal to avoid claim denials.
Action Required
By February 16, 2026: (1) Billing and provider staff must register and obtain access to the Cohere Health provider portal for prior authorization submissions. (2) Update internal workflows and billing system alerts to require prior authorization submission to Cohere Health BEFORE scheduling or billing for any facility-based sleep studies under GHP plans. (3) Configure billing software to distinguish between facility-based sleep studies (requires prior auth) and at-home sleep studies (no prior auth needed). (4) Communicate to all providers and front desk staff the new Cohere portal workflow and contact information for support. (5) Complete mandatory training on portal navigation provided by Cohere Health. Failure to obtain prior authorization through Cohere Health before submitting claims for facility-based sleep studies will result in claim denials.