Cohere Health snaps up $90 million to automate the highly-watched previous authorization process
Cohere Health ended a $90 million $90 million Wednesday, with its total funding reaching $200 million so far.
The 2019-based Boston company aims to address inefficiencies and administrative burdens associated with traditional prior authorization processes. By simplifying this process, Cohere is trying to reduce treatment delays and reduce the workload of healthcare providers, CEO Siva Namasivayam said.
He explained that the startup automates prior authorization by digitizing authorization requests and using AI to evaluate it on healthcare guidelines. Namasivayam noted that the system integrates with providers’ EHRs, which can propose provider submissions faster and propose faster care decisions for clinicians.
A 2024 survey by the American Medical Association showed that 93% of doctors said that prior authorization caused delays in patients’ care – while a quarter said prior authorization led to serious adverse events in patient care.
Cohere mainly sells its platform to health plans and at-risk providers. Namasivayam said the company has health plan clients in all 50 states. He added that the plans include national and regional plans, including the Geisinger Health Plan and Medical Mutual Assistance and Blue Branches.
He also noted that Cohere is working with nearly 600,000 providers and is processing more than 12 million prior authorization requests each year.
Namasivayam identified Legacy Liperacy Management suppliers as Cohere's main competitors and said his startup distinguishes itself from those companies through its technical quality.
“Integrated with it is its clinical intelligence, precise approach to AI and its tailored approach – currently providing providers with well-planned experiences to improve patient health outcomes. Cohere’s technology is designed to accelerate recognition, never denying care – and these decisions remain in human clinicians,” he said.
Cohere's C Series is led by Temasek, with participation from Flare Capital Partners, Deerfield Management, Dewine Ventures, Longitude Capital and Polaris Partners.
Michael Greeley, general partner of Flare Capital, said in a newsletter Wednesday that high-level investors’ interest in Cohere is two major factors – the leadership team’s clinical and technical expertise and “large and obvious” market opportunities to reduce the costs and burdens associated with previous authorizations.
“Being a recognized innovation category leader, associated with legacy suppliers, established investor joint organizations ensures that prospects think they must interact with the company to understand the “art of possible,” Greeley writes, brings you a large sales pipeline and an impressive customer.”
In his opinion, this huge financing consolidates Coement Cohere as an emerging champion in the previously authorized technology category.
Photo: Andranik Hakobyan, Getty Images
