Cohere Health vs Infinitus Systems (2026)
Read together, these two show AI on both ends of the same transaction, and increasingly on the same side. Cohere Health sells health plans clinical AI for utilization management, payment integrity, appeals, care management and policy work, with models that auto determine prior authorization requests in real time and APIs that carry provider submissions. Infinitus Systems began by automating the provider's phone call to the plan, and now also sells payors voice agents for member services calls and outbound health risk assessments. A health plan buying prior authorization and payment integrity looks at Cohere. A plan buying member service calls, or a provider or manufacturer automating payer calls, looks at Infinitus.
- Built for health plans, applying clinical AI across utilization management, payment integrity, appeals, care management and policy work.
- Prior authorization APIs, including the CMS prior authorization interfaces, embed Cohere's review in a plan's own systems.
- Human review alongside more than 450 clinically trained models.
- Member services calls for payors, plus outbound health risk assessments and medication adherence check ins.
- The provider side of the payer call automated end to end, with results written back as structured data.
- A clinical escalation feature that scores patient calls against the Schmidt-Thompson protocol and hands urgent ones to a nurse, staff or 911.
This comparison is published by AI Health Index, an independent research platform that compares healthcare AI vendors objectively. Cohere Health and Infinitus Systems are each graded against the same capability taxonomy, from each vendor's own public materials and the regulatory record, under the AI Health Index verification standard. No vendor pays for placement, and no vendor has reviewed this page. How this evidence is graded
Plain facts
| Fact | Cohere Health | Infinitus Systems |
|---|---|---|
| Primary category | RCM & Prior Auth AI | RCM & Prior Auth AI |
| Founded | Not recorded | 2019 |
| Headquarters | Boston, Massachusetts | San Francisco, California, United States |
| Website | coherehealth.com | infinitus.ai |
Side by Side
Select any grade to read the note behind it.
Product updates
The latest logged changes from each vendor, newest first, each linked to its source.
Cohere Health
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Product / capability
Cohere Health extended its intake, decision and review tools on Cohere Unify to medical benefit drugs, the specialty and provider administered drugs that run through a plan's medical benefit rather than its pharmacy benefit.
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Clinical evidence
Cohere Health published performance results for Cohere Capture, which extracts HEDIS gap closures and denominator exclusions from clinical data a health plan already holds, including prior authorization notes, imaging reports and EHR data.
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Product / capability
Cohere Health acquired ZignaAI in September 2025 and launched the Cohere Payment Integrity Suite, extending its clinical AI from pre service prior authorization into post service claims and coding validation.
Source
Infinitus Systems
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Product / capability
Infinitus's payer calling agents can now identify the right pharmacy benefit manager from the BIN and PCN printed on most member ID cards, rather than from a payer ID mapped in advance.
Source
Each vendor in one paragraph
Written to be quoted whole. Each paragraph opens the AI Health Index profile of the vendor: what the product is, who buys it and what it does.
Cohere Health sells a clinical intelligence platform, Cohere Unify, to health plans. Its modules cover utilization management, payment integrity, appeals, care management, claims operations and HEDIS quality work. Prior authorization requests arrive through Cohere's portal, its APIs, Availity, NaviNet or a provider's Epic workflow.
Source: AI Health Index, August 2026
Voice AI agent platform for the calls that stand between a patient and a prescribed treatment. Its agents call payers and pharmacy benefit managers to verify benefits and eligibility and follow up on prior authorizations, appeals and claim status, call provider offices to collect missing enrollment information, and return the results as structured data to the workflow that asked; copilots work the phone menu and the hold, then hand a staff member a live representative.
Source: AI Health Index, August 2026
Questions buyers ask
How do Cohere Health and Infinitus Systems work with the EHR?
Cohere's platform page also names Availity, NaviNet and Rhyme as routes in, and lists the CMS-0057-F prior authorization APIs (coverage requirements, documentation templates and prior authorization support) built to the HL7 Da Vinci guides. Plans can embed the service in their own systems through Cohere's APIs, and providers can also use its portal.
With Infinitus Systems, the product page says the agents and copilots can be launched from within Epic, Cerner, athenahealth and Salesforce, and call results are returned as structured data to the provider, payer, hub, specialty pharmacy and manufacturer workflows that asked for them rather than left as a transcript. From the AI Health Index, drawn from each vendor's own published materials and the regulatory record, verified August 4, 2026. No vendor pays for placement.
How are Cohere Health and Infinitus Systems priced and sold?
Cohere sells to health plans in three shapes: a platform the plan's own clinicians run, delegated utilization management run by Cohere's clinicians for named specialties, and APIs embedded into plan systems; payment integrity is sold in house or as a managed audit service. The only economics published are returns, up to 18x for prior authorization and 9x for payment integrity, which say what a plan gets back and not what it pays.
For Infinitus Systems, the home page claims up to five times return, with no basis. From the AI Health Index, drawn from each vendor's own published materials and the regulatory record, verified August 4, 2026. No vendor pays for placement.
How do Cohere Health and Infinitus Systems handle patient data?
Cohere's AI principles state the AI never uses explicit patient identifiers, such as names or locations, for care recommendations, and its AI Hub describes a minimum necessary approach that reads only the clinical information a decision needs.
In Infinitus Systems' case, the privacy policy, which covers people who speak with the agents, adds that personal data may be used to improve the functionality of the services, which sits uneasily with the contract-purpose commitment. From the AI Health Index, drawn from each vendor's own published materials and the regulatory record, verified August 4, 2026. No vendor pays for placement.
Which settings and specialties do Cohere Health and Infinitus Systems cover?
In October 2026 Cohere brought medical drug utilization management onto the same platform as medical review. The Humana case study supports prior authorization across all 50 states for Medicare Advantage and commercial members.
With Infinitus Systems, the agents verify benefits and eligibility, follow up with payers on prior authorization and claim status, call provider offices for information missing from program enrollments, and check financial assistance and copay eligibility. From the AI Health Index, drawn from each vendor's own published materials and the regulatory record, verified August 4, 2026. No vendor pays for placement.
Related comparisons
Other published head to head assessments involving these vendors or their closest peers.
A plan remains responsible for prior authorization compliance whatever vendor it uses.
Infinitus's triage feature leaves the calls it scores as not urgent without a clinician's decision; ask what happens to those. Recording consent for automated calls sits with the calling organization. Ask both how they check that their models perform evenly across member groups.