Cohere Health has announced a major leap in healthcare payment accuracy with the acquisition of ZignaAI and the launch of its new Payment Integrity Suite. This move promises faster, more precise claims processing for health plans and providers, using advanced clinical artificial intelligence. As the healthcare industry faces ongoing challenges with waste, delays, and transparency, this innovation could mark a significant shift.
Cohere Health Acquires ZignaAI to Boost Clinical AI Capabilities
The integration of ZignaAI into the Cohere Health ecosystem accelerates their “shift right” strategy. By leveraging ZignaAI’s expertise in AI-driven payment integrity and revenue optimization, Cohere Health strengthens its clinical intelligence platform. CEO Siva Namasivayam emphasized that the acquisition will bridge the gap between care planning and payment, reducing administrative burden. This new partnership supports Cohere Health’s mission to ensure accurate, high-quality care while fostering better payer-provider collaboration.
New Payment Integrity Suite Promises Faster, Accurate Claims
The new Payment Integrity (PI) Suite, led by Cohere Validate™, is designed to enhance claims payment transparency and efficiency. The solution has already delivered impressive results, including:
- 30% efficiency gains for health plans
- 8-9x return on investment
- Significantly faster payments to providers
By unifying data from prior authorization and post-service claims, Cohere Health aims to create a cohesive and collaborative payment ecosystem. This approach helps minimize errors, reduce waste, and ensure providers receive timely, accurate payments.
ZignaAI Integration Drives Transparent, Data-Driven Payments
ZignaAI’s artificial intelligence technology is at the core of this transformation. The PI Suite offers three key components:
- Cohere Validate™: In-house audit solution that streamlines clinical and coding validation for health plans using AI.
- Cohere Match™: Proprietary claims-to-authorization reconciliation to prevent overpayments before they happen.
- Cohere Complete™ for PI: A transparent, AI-powered end-to-end audit management alternative to legacy vendors.
These tools bring evidence-based, automated, and transparent processes to claims payment, helping plans catch errors early while providing providers with much-needed transparency and faster resolutions.
In summary, Cohere Health’s acquisition of ZignaAI and the launch of its Payment Integrity Suite signal a new era in healthcare payments. By deploying advanced clinical AI, Cohere Health is setting new standards for accuracy, collaboration, and efficiency in the industry. This approach promises to not only reduce waste but also build trust among providers and payers, ultimately benefiting patients and the entire healthcare system.
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