JSON twin: https://www.healthaidb.com/software/cohere-health.json
Cohere Health
https://coherehealth.com/utilization-management-suite
Cohere Health is an AI-powered clinical intelligence platform that automates and optimizes utilization management and prior authorization for health plans and provider workflows.
Cohere Health uses machine learning and clinical rules to digitize prior authorization, automate medical review (up to ~90% touchless approvals reported), integrate payer policies and evidence, provide real-time analytics, and support FHIR-based integrations (Cohere Connect) and EHR connectors to streamline decisions and reduce administrative burden.
yes
2019
P0373
2025-09-07
commercial proprietary
contact vendor for pricing and deployment tiers; enterprise contracts and implementations (trial/contact sales)
enterprise_quote
2019
product
1.0
{
"company_name": "Cohere Health",
"company_url": "https://coherehealth.com/",
"company_offices": [
"United States"
],
"company_founding": "2019",
"product_url": "https://coherehealth.com/utilization-management-suite",
"categories": [
"clinical",
"administrative",
"care management",
"utilization management",
"interoperability",
"AI/ML"
],
"market_segment": [
"enterprise"
],
"links": [
"https://coherehealth.com/",
"https://coherehealth.com/utilization-management-suite",
"https://coherehealth.com/unify-platform",
"https://coherehealth.com/review-assist",
"https://coherehealth.com/news/cohere-addresses-prior-authorization-compliance-gaps",
"https://coherehealth.com/news/cohere-health-earns-ncqa-certification-for-digital-prior-authorization-platform",
"https://coherehealth.com/blog/cohere-health-receives-hitrust-recertification",
"https://coherehealth.com/our-story/",
"https://coherehealth.com/press/",
"https://www.linkedin.com/company/coherehealth"
],
"summary": "Cohere Health is an AI-powered clinical intelligence platform that automates and optimizes utilization management and prior authorization for health plans and provider workflows.",
"description": "Cohere Health uses machine learning and clinical rules to digitize prior authorization, automate medical review (up to ~90% touchless approvals reported), integrate payer policies and evidence, provide real-time analytics, and support FHIR-based integrations (Cohere Connect) and EHR connectors to streamline decisions and reduce administrative burden.",
"target_users": [
"health plans / payers",
"utilization management teams",
"medical reviewers / clinicians",
"provider authorization teams",
"care managers",
"health plan administrators"
],
"specialties": [
"utilization management",
"prior authorization",
"radiology / imaging",
"surgical procedures",
"specialty medications / pharmacy",
"ambulatory procedures",
"behavioral health"
],
"regions_available": [
"United States"
],
"languages_supported": [
"English"
],
"pricing_model": "enterprise_quote",
"pricing_details": "contact vendor for pricing and deployment tiers; enterprise contracts and implementations (trial/contact sales)",
"license": "commercial proprietary",
"deployment_model": [
"SaaS/API-Based",
"In-house",
"Delegated/hybrid"
],
"os_platforms": [
"Web"
],
"features": [
"AI-driven prior authorization automation",
"Clinical intelligence engine (evidence-based models)",
"Policy and rules automation (NCDs/LCDs/custom guidelines)",
"API-based prior authorization (CMS-0057-F support)",
"Provider collaboration/workflow tools",
"Real-time analytics and reporting",
"Approval automation (auto-decisions)",
"Peer-to-peer physician review support",
"Provider portal / check auth status",
"Modular UM workflows (specialty-specific)",
"Implementation services and change management"
],
"optional_modules": [
"Review Assist",
"Align",
"Delegated services (full-service UM)",
"In-house UM implementation blueprint"
],
"integrations": [],
"data_standards": [
"FHIR",
"DaVinci (FHIR implementation projects)",
"CMS-0057-F"
],
"api_available": "yes",
"system_requirements": "",
"compliance": [
"CMS-0057-F",
"HIPAA"
],
"certifications": [],
"security_features": [],
"privacy_features": [],
"data_residency": "",
"customers": [
"Humana",
"Geisinger Health Plan",
"Medical Mutual",
"BlueCross BlueShield of South Carolina",
"Office of the National Coordinator for Health IT",
"Multiple regional and national health plans (unnamed)"
],
"user_reviews": [
"Love being able to work remote! I have a great work/life balance with this company. Training is great and the pay is competitive. Benefits are good too!",
"Great springboard position to get your foot in the door of utilization management/ review.",
"Pay is subpar and below national average. Minimal advancement.",
"Working with Cohere has been transformational for prior authorization workflows — reduced provider burden reported by plans.",
"Provider portal registration in less than 10 minutes; makes submitting authorizations easier (provider feedback)."
],
"ratings": [
"Glassdoor: 3.2/5 (employee reviews)",
"Blind: 3.7/5 (employee reviews)"
],
"support_channels": [
"email",
"phone",
"chat",
"ticketing",
"webinars",
"provider resources/knowledge base"
],
"training_options": [
"documentation/user guides",
"webinars",
"live_online training",
"onsite training"
],
"release_year": "2019",
"integration_partners": [
"MCG Health",
"Hiver (customer support tooling integration)",
"AVIA (marketplace listings/partners)",
"Health plan integrations (API-based integrations with client case systems)"
],
"id": "P0373",
"slug": "cohere-health",
"type": "product",
"version": "1.0",
"last_updated": "2025-09-07",
"links_json": {
"self": "https://www.healthaidb.com/software/cohere-health.json"
}
}