Cohere Health
AI prior auth that speeds care
Cohere Health is an AI-driven prior authorization platform that automates a significant portion of prior authorizations and integrates with EHRs for in-workflow authorization.
Source: Digital.Health
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How We Help
Why it matters
Prior authorization is a major administrative bottleneck. Cohere targets payer-provider collaboration, specialty UM, and faster care decisions.
What the company reports
Claims are attributed to their source and not independently verified unless noted.
Who it's for
Problem Statement
The inefficiency and burden of prior authorizations in healthcare, which often lead to delays in patient care and increased administrative costs.
Core Technology
AI-driven prior authorization platform, FHIR API-enabled authorizations
Key Differentiators
Automates up to 90% of prior authorizations; Integrates with EHRs for in-workflow authorization; 85% of authorizations receive immediate determination (approved or flagged) by AI; No claim denial made exclusively by AI; all final denial decisions include human review by peer doctors or nurses; Supports FHIR-based electronic PA across in-house, delegated, and API offerings; Compliant with CMS Interoperability & Prior Authorization Final Rule (CMS-0057-F)
Clinical Focus
Musculoskeletal Care; Cardiology; Pain Management; Physical Therapy; Diagnostic Imaging; Sleep
Company Info
- Business Model
- B2B2C
- Founded
- 2019
- Total Funding
- 200,000,000
- Website
- coherehealth.com
Categories
Disease Areas
Technologies
Clinical & IP
Clinical Validation
CMS-0057-F compliant with FHIR API. Validated through real-world deployment: 12 million prior auth requests annually, 94% provider satisfaction, 85% real-time approval rate. No formal FDA trials (platform is not a medical device).
MedStartr Index Score
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