Cohere Health develops AI-powered clinical intelligence software for the healthcare industry, focusing on prior authorization automation and payment integrity. The platform enables health plans and providers to streamline utilization management by automating prior authorization decisions whilst maintaining clinician oversight and auditability. Its machine learning models are precision-trained on clinical documentation rather than generic text, distinguishing it from broader AI approaches.
The company processes more than 12 million prior authorization requests annually across a network of over 660,000 providers. Its platform approves up to 85% of authorizations in real-time, reducing administrative burden on both payers and providers. Cohere Health's payment integrity solutions are designed to reduce waste, improve collaboration between payers and providers, and ensure timely and accurate payment processing.
The platform operates at the intersection of clinical decision support and healthcare operations automation, with particular emphasis on responsible AI practices that preserve clinician judgment and system transparency. This focus on auditability and clinician oversight reflects the company's approach to deploying AI in a regulated industry where clinical accountability remains paramount.