Cohere Health

We’re proud to announce today that Cohere Health will bring together our AI-powered prior authorization capabilities with Microsoft Dragon Copilot to automate care requests made by healthcare providers. 🤝 Our Chief Digital and Technology Officer, Gus W., shares his insights on the collaboration: “By integrating our AI agents into clinicians’ existing workflows, Cohere Health provides deeper clinical insight and eliminates calls and faxes that traditionally consume valuable team time. Harnessing ambient AI for prior authorization will allow clinicians to keep their focus where it belongs: on delivering exceptional, high-quality patient care.” This collaboration with Microsoft for Healthcare will help clinicians secure approvals in real time at the point of care–meaningfully reducing administrative burden and accelerating patients' access to necessary care. 🎯 Learn more here 👉 https://lnkd.in/dKyPpNQZ.

Cohere Health is leading the way for responsible innovation in healthcare. That's why we chose Amazon Bedrock AgentCore for our first production deployment of agentic healthcare AI. 🤝 Using AgentCore, we built and deployed Cohere Review Resolve™, our AI-powered copilot that optimizes the accuracy and efficiency of health plan medical necessity reviews. 🎯 Review Resolve scours both structured and unstructured data–such as clinical records, patient notes, and faxes–quickly identifying and surfacing evidence to validate the medical necessity of a requested treatment. Our copilot provides health plans’ reviewers with complete clinical context for prior authorization requests and responds intelligently to reviewers’ queries. AgentCore’s comprehensive audit trails, extended session support, and ability to maintain clinical decision history throughout complex multi-hour workflows were essential for us. Thank you to Matt Garman for the mention. We're thrilled to partner with the AgentCore and AWS teams. 🚀

Health plans have chased cost containment at every stage of the claim lifecycle, but returns are shrinking, and provider abrasion and costs are rising. What if the solution is thinking fundamentally about new ways to approach the problem? 💡 Let's dive into it, with expert insights from Monique Pierce, who leads payment integrity solutions at Cohere Health. Learn how a unified approach, here UM, claims, and payment integrity capabilities intersect, provides more opportunity than standard PI programs alone 👉 https://lnkd.in/eBHXU5pe.

Most clinicians and office professionals say prior authorization is a burden, but I was shocked to learn that the majority see AI as a way to relieve the burden and achieve greater collaboration. Fierce Healthcare highlighted a few key takeaways from our national provider survey, including: • Most office administrators (95%) and clinicians (92%) say prior authorization is a significant burden. • Yet more respondents trust using AI for prior authorization approvals–99% of clinicians and 96% of administrators. • Technology is important to reducing the burden, with 2/3 of respondents saying a digital process would significantly improve their workflows. As a clinician, I've experienced first-hand how transparency and collaboration around prior authorization can improve patient outcomes, and benefit both plans and providers. Read the Fierce piece here for more from Cohere Health's findings: https://lnkd.in/eWrpEhhb.

Elion's new AI Prior Authorization Buyer's Guide identifies three forces converging right now to underscore the timely need for change in prior authorization (PA). ⏳ • Policy: Explicit CMS-0057-F compliance deadlines are rapidly approaching. • Labor math: Providers need modern, efficient solutions. Our national survey of 200 providers found 1 in 10 link PA burden to burnout, with ever-increasing operational strains. • Technology: Mature, AI-driven automation solutions are at the ready to transform prior authorization. 👉 The reality is that 93% of the clinicians we surveyed have seen PA delays lead to avoidable hospitalizations. And only 7-12% receive decisions within the federal timelines taking effect in 2026. Elion positions payer-side platforms like Cohere Health as essential infrastructure for this shift–partners that enable faster decisions, better interoperability, and improved payer-provider collaboration. We're already helping health plans transform PA, processing millions of authorizations annually, with AI auto-approving up to 90% of requests. For health plans figuring out where to start, this guide is an excellent roadmap. Read more here: https://lnkd.in/epZn8GjU.

Cohere Health today released findings from our 2025 National Provider Survey on Prior Authorization. After surveying 200 U.S. providers, we found nearly universal trust in using AI for prior authorization approvals. 💡 The numbers speak for themselves: 99% of clinicians and 96% of office administrators reported confidence in AI-driven prior authorization (PA). This endorsement signals the growing demand to reduce provider burden, improve care access, and transform PA. The data also highlights what’s at stake if legacy systems remain unchanged: • 97% of administrators and 93% of clinicians have seen PA delays cause avoidable emergency care or hospitalizations • 55% have witnessed patients abandon treatment because of PA delays • 95% of administrators and 92% of clinicians said PA is a burden We're committed to transforming prior authorization, helping health plans modernize UM workflows, protect patients from unnecessary risk, and give clinicians more time to focus on care. By integrating responsible, precision AI with clinical expertise and advanced digital innovation, we're making PA faster, smarter, and more transparent for all involved. 🤝 Read more here: https://lnkd.in/ePpidkPr.

Cohere Health is proud to be named a Best in Class finalist for the AI in Health Operations category at The Digital Health Hub Foundation - Digital Health Awards. We previously took home the award for 2024 Best AI Story. 🏆 Selected from among thousands of submissions worldwide, this recognition highlights how our clinical AI-powered approach to prior authorization significantly reduces manual reviews, lowers costs, and speeds up patients' access to the right care. We're committed to maintaining strict guardrails, data governance, and responsible AI principles–never using AI to deny care, only to help clinicians get to a faster “yes.” This clinician-led model ensures transparency, accountability, accuracy, and trust. 🤝 The 2025 winners will be presented at HLTH on October 20th, and celebrated before an audience of global healthcare leaders, investors, and innovators. Learn more here: https://lnkd.in/gA7Aerkj.

🎯 In the latest Cohere Insider, learn about our expansion into the payment integrity market, how your plan can break down silos–and unlock opportunity–by connecting utilization management and payments, and more.