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Cohere Health

Also known as: Cohere Unify

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Healthcare agentindependentVerified 2026-07-22

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

prior authorization automationutilization managementpayment integrityappeals reviewcare management

Target customers

health planspayersenterprise

Deployment options

SaaS

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.

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

Contact onlyHigh variable cost

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

Verified 2026-07-22

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