Cohere Health
Also known as: Cohere Unify
Clinical intelligence platform for health plans whose agentic AI automates up to 90% of prior authorization requests with 85% real time approvals, extending across utilization management, payment integrity, appeals, and claims via Cohere Unify.
Cohere Health builds clinically trained agentic AI for health plans. Its Cohere Unify platform combines domain specific AI, proprietary clinical context, workflow automation, and human expertise across utilization management, payment integrity, appeals, care management, quality, and claims operations. The company reports up to 90 percent of prior authorization requests automated with 85 percent real time approvals, the remainder always reviewed by a clinician before final determination, and appeal agents that surface decisive clinical evidence with full auditability. A Microsoft Dragon Copilot integration lets ambient listening trigger Cohere's agents at the point of care to collect and parse patient documentation in real time. Cohere acquired ZignaAI in September 2025 to expand into payment integrity, is designed for CMS-0057-F electronic prior authorization compliance, and reports up to 18x ROI with 94 percent provider satisfaction. Founded circa 2019 in Boston; recognized on TIME's World's Top HealthTech Companies 2025.
Vendor details
Canonical URL
https://www.coherehealth.com
Category
Healthcare agent
Funding status
Venture backed; acquired ZignaAI Sep 2025
Company status
independent
Use cases & customers
Primary use cases
Target customers
Deployment options
Integrations
Pulls structured and unstructured clinical data from patient notes and orders; Microsoft Dragon Copilot ambient integration triggers agents at the point of care; CMS-0057-F API compliance focus.
Sources & related URLs
Capability coverage
7.5 / 14 capabilities · 54%
| Integrations & Tool CallingPulls structured and unstructured data from patient notes, documentation, and orders with a Dragon Copilot partner integration, but no broad integration catalog is documented, Cohere materials 2026-07-22 | Partial |
|---|---|
| Workflow OrchestrationCohere Unify combines domain specific AI, workflow automation, and human expertise across UM, payment integrity, appeals, care management, quality, and claims from a single connected platform, Cohere site 2026-07-22 | Full |
| Knowledge Grounding & RAGClinician crafted AI models grounded in real world prior authorization decisions and evidence based guidelines developed and validated by practicing physicians, Cohere agentic AI blog 2026-07-22 | Full |
| Human Oversight & GuardrailsPrior authorization submissions not approved in real time are reviewed by a clinician before final determination, and appeal agents assist human reviewers rather than deciding, Cohere site 2026-07-22 | Full |
| Security, Identity & GovernanceTransparent auditable decision making designed to support health plan compliance obligations; no specific security certifications documented in retrieved materials, Cohere materials 2026-07-22 | Partial |
| Observability & AuditabilityTransparent, auditable decision making is a stated design principle, with appeal reviews completed with greater consistency and full auditability, Cohere site 2026-07-22 | Full |
| Memory & State PersistenceNo documented persistent agent memory or cross case learning capability, Cohere materials 2026-07-22 | Unable to verify |
| Deployment & Data ResidencyEnterprise SaaS platform for health plans; no self host or residency options documented, Cohere materials 2026-07-22 | Partial |
| Prebuilt Agents, Templates & PacksIntegrated and standalone agentic solutions spanning policy management, UM, and payment integrity, with care management, appeals, quality, and claims use cases approaching, Cohere agentic AI blog 2026-07-22 | Full |
| Triggers & Channel CoverageDragon Copilot ambient listening triggers Cohere's AI agents in real time at the point of care to collect and parse relevant patient documentation, Cohere ambient PA announcement 2026-07-22 | Full |
| Model Flexibility & RoutingProprietary clinically trained models; no customer facing model choice or routing, Cohere materials 2026-07-22 | Unable to verify |
| APIs, SDKs & MCP ExtensibilityCMS mandated interoperability APIs are referenced but no public developer SDK or extensibility surface is documented, Cohere materials 2026-07-22 | Unable to verify |
| Testing, Debugging & OptimizationNo customer facing testing or evaluation tooling documented, Cohere materials 2026-07-22 | Unable to verify |
| Browser & Computer UseOperates on clinical documents and payer workflows, not browser or computer interface control, Cohere materials 2026-07-22 | Unable to verify |
Pricing
Contact sales
What is public
No public pricing. Cohere publishes value framing: up to 18x ROI for Unify, 8x to 9x for payment integrity, and up to $96 per member per year first year recoveries for Validate.
Variable cost rationale
Enterprise platform for health plans scoped by covered lives and modules across UM, payment integrity, and appeals; vendor publishes ROI multiples (8x to 18x) and recovery figures ($96 PMPY) but no rates.
Sales call required
Yes — required for paid access
Free / trial
None public
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