Cohere Health Acquires ZignaAI to Launch AI-Powered Payment Integrity Suite

Cohere Health, a clinical intelligence solutions provider, has acquired ZignaAI to establish a comprehensive Payment Integrity Suite, marking a significant shift in how health plans approach claims validation and payment accuracy. The acquisition, for which financial terms were not disclosed, combines ZignaAI's AI-driven payment integrity technology with Cohere Health's clinical intelligence platform to address longstanding challenges in healthcare payment systems.

Founded in 2020, ZignaAI brought specialized expertise in natural language processing and machine learning applications for payment integrity and revenue optimization. The company's technology automates coding and clinical validation processes for health plans, creating efficiencies that have already demonstrated measurable impact. According to Cohere Health, the new solution has delivered 30% efficiency gains and 8-9x return on investment for health plan clients, while enabling faster payment processing.

The Payment Integrity Suite centers on Cohere Validate™, an AI-powered solution that performs near real-time clinical and coding validation. This platform modernizes complex claims reviews across inpatient, outpatient, and professional programs, enabling health plans to conduct high-value reviews internally rather than relying on external vendors. The system's precision AI has been trained on reimbursement policies, codes, and clinical data to provide faster, more accurate validation with clear audit rationale.

Traditional payment integrity has been characterized by opaque "black box" algorithms from legacy vendors that often create friction between payers and providers. Cohere Health's approach shifts post-payment reviews upstream, catching errors before claims are paid. This proactive methodology reduces financial waste while improving provider relationships through increased transparency and faster payments. The suite includes Cohere Match™, which reconciles claims to pre-care authorizations to identify mismatches before payment, and Cohere Complete™ for Payment Integrity, offering AI-powered audit management services as an alternative to legacy outsourced vendors.

"We're thrilled to welcome the ZignaAI team to Cohere Health and to launch our Payment Integrity Suite," said Siva Namasivayam, CEO and co-founder of Cohere Health. "The 'shift right' is a natural evolution of our clinical intelligence platform, allowing us to bring the same precision AI approach that drove our success in UM: real-time approvals; appropriate, high-quality care for patients; and reduced administrative burden for both payers and providers. Our platform bridges the gap between care planning and payments for better healthcare economics, payer-provider partnerships, and patient outcomes."

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