Agent Rank breakdown
- Autonomy
- 9
- Capabilities
- 6
- Integrations
- 2
- Pricing
- 4
- Polish
- 5
- Verifiability
- 6
Auto-computed from autonomy, capabilities, integrations, pricing, maturity and editorial verification. Updated every deploy. How is this computed?
Capabilities
- Tool use
- Memory
- RAG
Integrations
- Other
- EpicCernerInsurance Payers
Pricing tiers
- +Prior-auth automation
- +CMS-0057 compliance
- +API integration
- +Real-time approvals
- +Denial appeals automation
- +Epic + Cerner integration
- +Custom workflows
- +Cross-plan orchestration
- +Strategic CS
Pros & cons
- +$150M+ raised; CMS-0057 compliance built-in — required for 2026 payer rules
- +85% real-time prior-auth approvals — best-in-class automation rate
- +9M+ authorizations processed; major payer + provider customers
- −Two-sided market dependency — needs payer AND provider adoption
- −Heavy regulatory complexity — implementation requires legal review
- −No self-serve tier — enterprise sales only
Clinical-intelligence agents enabling 85% real-time prior-auth approvals — CMS-0057 compliant. Start with the subscription tier.
Frequently asked questions
What is Cohere Health?+
Cohere Health is a clinical-intelligence agent platform that automates prior authorization between payers and providers. Enables 85% real-time approvals and is CMS-0057 compliant.
Cohere Health vs Innovaccer?+
Cohere is prior-auth-specialized (depth in this one workflow); Innovaccer Gravity is broader RCM (prior auth + denial appeals + claims). Many systems run both — Cohere for prior auth, Innovaccer for downstream RCM.
What is CMS-0057?+
CMS-0057 is the 2026 CMS rule mandating that payers respond to prior-auth requests in real-time (typically within 7 days for standard requests). Cohere Health is built around this requirement.
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