It’s 2025, and prior authorization is still the DMV of healthcare, slow, bureaucratic, and borderline medieval. But while most are still stamping forms in triplicate, Cohere Health is building something that actually works. Something that makes payers and providers stop grinding gears and start syncing like a Sasha and Digweed set at Twilo, precise, immersive, and impossible to ignore.
Founded in 2019, Cohere was never chasing buzzwords. Siva Namasivayam and Duncan Reece saw the $600 billion elephant in the room, administrative waste, and decided to do something about it. Fast-forward six years and they’ve landed a fresh $90M Series C, led by Deerfield Management with backup from Define Ventures, Flare Capital Partners, Polaris Partners, and Longitude Capital. That puts Cohere’s war chest at $186.1M. Not bad for a company that didn’t just enter the chat, they reprogrammed the room.
While others built yet another layer of red tape, Cohere built Cohere Unify™, a clinical intelligence engine trained on 40 million prior auth decisions that doesn’t just process forms, it predicts approvals, anticipates denials, and guides treatment like a GPS for care. The kind of platform that makes 89% first-pass approvals and 42% faster treatment times feel less like goals and more like standards. They’re clocking 2.3 million auths a month, with a 93% digital adoption rate and an ARR north of $112M. That’s not SaaS, that’s sustained precision at scale.
But here’s where it gets Cohere-level interesting. They’ve got boots in 48 states, run a multi-cloud, FHIR standard engine stacked with Scala, Python, and CockroachDB, and yeah, they’re HIPAA-hardened with SOC 2 Type II and HITRUST CSF. Try faking that kind of infrastructure swagger. You can’t.
The leadership? Siva is the guy who scaled SCIO Health Analytics® from zero to $90M before exiting for $240M. Toby Rogers came in hot from UnitedHealth. Matt Parker brought the product IQ from Olive AI. Elif Eracar knows client experience like she wrote the manual. When your board includes Rebecca Springer, PhD, Lynne Chou O'Keefe, Dave Barrett, and Oscar Health’s Kevin Nazemi you’re not “making waves.” You are the current.
This isn’t a pivot. It’s a precision-tuned blitz on healthcare’s most painful inefficiencies. From Medicare Advantage to Medicaid, from predictive denial avoidance to real-time auth guarantees, Cohere’s not just scaling, they’re shaping the new standard. They’ve got the clinical depth, regulatory agility, and EHR integrated workflows to own this space.
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