CH

Cohere Decision

Application

by Cohere Health

Cohere Decision makes prior authorization decisions using health plan-preferred policies.

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What it does

• Document extraction

Features 3

• Real-time prior authorization decisionsAutomates the majority of prior authorization decisions, approving many in real time.
• Policy digitization and codificationDigitizes and codifies coverage guidelines so automated decisions follow plan policy.
• EHR and UM integrationsConnects with major EHR systems, UM systems and administrative tools.

Sources

Pricing

Official documentation · 14 Oct 2026

"Contact the Cohere Team"

Description

Official documentation · 14 Oct 2026

"Real-time prior authorization decisions using health plan-preferred policies"

What it does

Official documentation · 14 Oct 2026

"structure all relevant clinical information"

Sold within

Official documentation · 14 Oct 2026

"Cohere Decision is part of a comprehensive platform"

Name

Official documentation · 14 Oct 2026

"Cohere Decision combs through"

URL

Official documentation · 14 Oct 2026

"Cohere Decision combs through"

Deployment

Official documentation · 14 Oct 2026

"The Unify platform uses AWS"

Also from Cohere Health

• Cohere Unify Platform

  Cohere Health's platform for health plans, connecting clinical intelligence across utilization management, payment integrity, appeals, care management, quality and claims operations.

• Cohere Review Assist Application

  Fine-tuned models that surface and cite the clinical indication buried in a prior-authorisation attachment, inside a health plan's existing utilization-management system.

• Cohere Review Resolve Application

  Automates the medical-necessity review end to end — surfacing guidelines, answering case questions through the Casey assistant and generating compliant determination letters.

• Cohere Align Application

  Segments providers into cohorts and tailors each one's prior-authorisation workflow and touchpoints, with behaviour analytics in place of a flat gold-carding programme.

• Policy Studio Application

  Turns a health plan's written medical policy into digitised, machine-readable assets that the rest of the platform decides against.

• Auth Match Application

  Reconciles submitted claims against the authorisations that were granted, as a payment-integrity add-on to Cohere's utilization-management products.

• Cohere Intake Application

  Cohere Intake digitizes prior authorization requests into an automated workflow.

• Cohere Validate Application

  Cohere Validate uses AI to analyze claims against medical records and validate clinical evidence.

• Cohere Appeals Assist Application

  Drafts structured review notes for clinical appeals.

• Cohere Capture Application

  Extracts clinical evidence and formats gap closures for submission to HEDIS systems.

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