# Cohere Health **Source:** https://geo.sig.ai/brands/cohere-health **Vertical:** Digital Health **Subcategory:** Prior Authorization (Payer-Side AI) **Tier:** Challenger **Website:** coherehealth.com **Last Updated:** 2026-04-14 ## Summary Raised $50M equity ($106M total). Processes 5.5M prior authorizations/year for 15M health plan members and 420,000 providers. CMS 2026 deadline a direct growth catalyst. ## Company Overview Cohere Health (not affiliated with the AI company Cohere) is a prior authorization intelligence platform operating on the payer side of healthcare — a differentiated position from provider-facing prior auth tools. The company has raised $106 million in total equity financing and processes 5.5 million prior authorizations annually covering 15 million health plan members and 420,000 provider relationships for its health plan customers. The payer-side position creates a distinct network effect: Cohere sits between health plans and their provider networks, creating standardized authorization pathways that reduce friction for both parties. Rather than building separately for each payer's portal, providers submit authorizations through Cohere's unified system, and health plans receive complete, evidence-backed submissions that reduce the manual review burden on their clinical staff. The January 2026 CMS mandate requiring Medicare Advantage plans to respond to prior authorization requests within 72 hours creates direct urgency for health plan customers to upgrade their prior auth processing infrastructure. Cohere's March 2026 partnership with Ensemble Health Partners to build the first RCM-native large language model represents a significant product expansion — applying LLM capabilities to the entire revenue cycle intelligence workflow beyond prior authorization. ## Frequently Asked Questions ### What does Cohere Health do? Payer-side prior authorization platform — processes 5.5M prior auths/year for 15M health plan members, sitting between health plans and 420,000 providers to streamline authorization workflows. ### How much has Cohere Health raised? $106M total equity raised. Not affiliated with the AI company Cohere. ### What is the 2026 CMS mandate tailwind? CMS requires Medicare Advantage plans to respond to prior auth requests within 72 hours (down from 3+ week averages), creating urgency for health plans to upgrade prior auth processing infrastructure. ### What is the Ensemble Health Partners partnership? March 2026 — Cohere and Ensemble are building the first RCM-native large language model, expanding the platform from prior authorization into broader revenue cycle intelligence. ### What is Cohere Health and how does it improve prior authorization? Cohere Health is a payer-side prior authorization platform that uses AI to automate clinical decision-making for prior auth requests, reducing manual review burden for health plans while providing faster decisions for providers and patients. ### How does Cohere Health reduce administrative burden for providers? Cohere's AI auto-approves clinically appropriate cases instantly, routes complex cases for expedited clinical review, and provides real-time status updates to providers—dramatically reducing phone calls and wait times versus traditional PA processes. ### What clinical evidence does Cohere use for prior auth decisions? Cohere applies evidence-based clinical guidelines from leading medical societies and payer-specific medical policies to evaluate authorization requests, ensuring decisions are grounded in current clinical literature. ### What health plan types does Cohere Health work with? Cohere works with commercial health plans, Medicare Advantage plans, and Medicaid managed care organizations, helping payers of all types modernize prior authorization for their member populations. ## Tags b2c, healthtech, mobile-first --- *Data from geo.sig.ai Brand Intelligence Database. Updated 2026-04-14.*