Cohere Health just locked in $90M of Series C funding to keep doing what it does best, offloading painful prior authorization processes from humans to AI.
Cohere works with health plans and risk-bearing providers to automate prior auth workflows and accelerate time to care… or at least quicker denials.
- The platform’s “precision clinical insights” mean up to 90% of requests can be auto-approved, slashing administrative burden and opening up bandwidth for more collaboration between physicians and payors on critical cases.
- Cohere’s been moving quickly. It’s raised 200M since launching in 2019, and now processes over 12M prior auths for 600k+ providers annually.
As an early mover in the booming segment, Cohere is doing more than digitizing an outdated prior auth system.
- Its AI facilitates new ways for plans and providers to collaborate while incorporating the best clinical evidence / guidelines, an approach that seems to be working.
- Cohere boasts a 93% provider satisfaction rating, and is now setting its sights on other areas of the healthcare ecosystem.
The Series C funds will accelerate Cohere’s next phase of growth, which involves scaling up its Cohere Unify platform and adding a thick layer of AI paint to the entire portfolio.
- Cohere Unify not only streamlines payor-provider collaboration, but also modernizes utilization management by personalizing provider workflows and optimizing engagement with real-time performance data.
- These capabilities are the foundation for Cohere’s broader vision of transforming clinical decision-making, and it sounds like we won’t have to wait long to see them expand to new use cases like synthesizing records when multiple departments are involved.
The Takeaway
Prior authorizations are a pain, full stop. If Cohere can use its Series C to give clinicians more time practicing at the top of their license instead of going back and forth with payors, that seems like a great outcome all around.
