Cohere Health replaces the traditional "fax-and-wait" prior authorization model with a digital intake process that sits between the provider and the health plan. When a clinician orders a service, the tool analyzes clinical data (often extracted directly from the EHR) against the payer’s policy guidelines in real-time. Instead of issuing a flat denial or requiring a manual review days later, the system attempts to "green-light" the request instantly or provides immediate "nudges" to guide the provider toward a pre-approved, evidence-based care path.

Myndshft is a background infrastructure tool that automates the "investigative" phase of patient intake and ordering. When a clinician orders a service or specialty drug, the software instantly queries payers to determine (1) if the patient is covered, (2) if a prior authorization is required, and (3) whether that authorization falls under the patient’s medical benefit or pharmacy benefit. If an authorization is required, it autopopulates the necessary forms with clinical data from your system and submits them directly to the payer, bypassing the need for staff to log into individual insurance portals.

HealOS uses AI "agents" to autonomously log into payer portals and databases to verify patient insurance coverage and submit prior authorization requests. Instead of staff manually calling insurers or navigating multiple websites, the software retrieves detailed benefit information (deductibles, copays, network status) and determines authorization requirements in the background, presenting the results directly to the administrative team.