- No public price. Sold to health plans. Billing period, trial and refund terms are not stated.
- Not disclosed
- Not disclosed
- —
- 2019
Billing & coding
Cohere Health
by Cohere Health · founded 2019
Payer-side: Prior authorization and utilization management platform for health plans (Cohere Unify). The vendor says 85% of requests are approved in real time.
On this page
18/100Tracked
- Regulatory & Compliance0/13.6
No FDA clearance listed
- Clinical Integration0/31.4
No EHR integrations listed
- Evidence Strength0/10
No peer-reviewed coverage
- Vendor & Market12.6/18
Mid-tier funding and adoption
- Sentiment & Transparency3.3/15.5
Pricing on request, no public amounts
▸ Show all 11 dimensions▾ Hide dimension detail
- FDA clearance0/4
No FDA clearance listed
- HIPAA / SOC2 / BAA0/10
No public HIPAA/SOC2/BAA attestation
- EHR integrations (count)0/18
No EHR integrations listed
- Top-3 EHR coverage (Epic / Oracle / Athena)0/8
None of the top-3 EHRs covered
- Bidirectional write-back0/5
No bidirectional write-back documented
- Peer-reviewed papers0/7
No peer-reviewed coverage
- RCT / meta-analysis / systematic review0/3
No RCT, meta-analysis, or systematic review
- Funding & adoption signal8/12
Mid-tier funding and adoption
- Years in market4/6
Founded 2019 (7 years)
- Clinician sentiment (Reddit)0/9
No clinician sentiment data available
- Pricing transparency3/7
Pricing on request, no public amounts
90% prior-auth automation claim. Unify platform for payer-provider workflows.
Payer-side AI focused on payment integrity and PA. Strong VBC alignment.
Bottom line
Cohere Health sells utilization management and prior authorization software to health plans. Payers are the customer, and providers meet the product as the intake and decision portal when they submit an authorization. It also sells payment integrity, appeals, care management and quality tools under the Cohere Unify platform brand. The performance numbers are the vendor's own.
What is Cohere Health and who sells it?
Cohere describes "connected clinical intelligence" across utilization management, payment integrity, appeals, care management, quality and claims operations. Its stated aim is to help plans "improve efficiency, quality, and financial performance while keeping humans in control."
The company is Boston-based per Fierce Healthcare and MedCity News. Most sources date it to 2019, with Siva Namasivayam as founder and CEO. A $90M Series C led by Temasek, with Deerfield also named, was announced on May 14, 2025. In September 2025 it acquired ZignaAI, which became its payment integrity product, Cohere Validate.
What does it claim?
- Prior authorization: "touchless prior authorizations," with 85% of requests approved in real time and the rest reviewed by a clinician. The figure is plan-wide and varies by specialty.
- Payment integrity: "9x ROI."
- Appeals: AI-assisted review that takes half the time, with decisions up to 40% faster.
- Quality: 20% to 25% closure rates on high-value HEDIS measures.
- Care management: surfaces rising-risk members and drafts care plans.
- Scale: 17 clients, 25M covered lives, 47M interactions and 94% provider satisfaction.
Each number is Cohere's. The vendor says the product works with existing EHRs, that requests arrive by EHR, fax and other channels, and that FHIR APIs handled 9M authorizations in the past year.
What about bias and security?
IntuitionLabs argues that models trained on historical data can reinforce bias without monitoring, and notes Cohere stresses transparency and human oversight. Cohere's pages state no HIPAA, SOC 2 or HITRUST status.
What do plans pay?
Plans buy it by contract, and the vendor publishes no price.
The verdict
A health plan that wants to automate prior authorization and pull payment integrity and appeals onto one platform is the buyer. A provider group has no reason to buy it, since it is the plan that picks it. The 85% real-time approval rate is plan-wide and varies by specialty, and 25M covered lives across 17 clients is the vendor's own count.
Editorial review last generated October 15, 2026. Synthesized from clinician sentiment, peer-reviewed coverage, and our editorial silo picks. Refined by hand where vendor facts change.
What it costs
All tiers are custom-quoted. The vendor does not publish per-provider list pricing.
| Tier | Monthly | Annual | Notes |
|---|---|---|---|
| Enterprise | — | — | No public price. Sold to health plans. Billing period, trial and refund terms are not stated. |
Source: vendor pricing page. Last checked October 15, 2026.
Who builds it
Cohere Health (Cohere Health) was founded in 2019, putting it 7 years into market.
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Common questions about Cohere Health
Answers below cover the most-searched clinician questions for Cohere Health in 2026. Updated as vendor docs and pricing change.