Cohere Health vs Infinx
Two Prior Authorization vendors, side by side. Facts from public sources; judgments are ours.
At a glance
Derived from public facts · a rough scale, not a ranking
| Cohere Health | Infinx | |
|---|---|---|
| Pricing model | Enterprise contract (custom) · scoped by UM volume and model | Enterprise contract (custom) · Software plus services, quote-based |
| Speed to go live | deep payer UM integration, multi-month program | Standard EHR integration project |
| Automation model | Software platform · AI-assisted utilization management decisioning | Tech-enabled service · AI agents plus expert staff |
| Built for | Payers | Mid-size groups, Enterprise systems, Billing companies |
| Security posture | HITRUST, HIPAA | HITRUST, SOC 2 Type II, HIPAA |
| Company maturity | 7 yrs (est. 2019) | 14 yrs (est. 2012) |
| Financial backing | $200M · Series C | $186M reported · Growth (KKR minority stake 2024) |
| Named customers | 3 named | None public |
| Published results | Specific numbers public | No public numbers |
| Documented integrations | 3 listed | 5 listed |
| Third-party validation | None found | None found |
Bottom line
- Pick Cohere Health if you are a health plan replacing legacy utilization management with AI-driven prior auth at Humana-proven scale.
- Pick Infinx if you want prior auth and revenue cycle work handled by a blend of AI and human specialists rather than buying software your staff must run.
Cohere Health
Intelligent prior auth platform for payers
- Founded
- 2019
- HQ
- Boston, MA
- Stage
- Series C
- Raised
- $200M
What it does
- Automates prior auth intake, review, and approval for health plans
- Auto-approves up to 90 percent of eligible auth requests
- Applies evidence-based clinical policies and physician-facing nudges
- Provider performance analytics to steer utilization management
- Payment integrity claims validation via Cohere Validate
- Delegated UM services across MSK, cardiology, imaging, sleep
Where it's strong
- Proven at national scale: over 12 million prior auth requests a year across roughly 600,000 providers, including a nationwide Humana deployment.
- High auto-approval rates (up to 90 percent) materially cut turnaround times and provider abrasion, which matters as CMS-0057 deadlines arrive.
- Well capitalized at $200M raised and expanding beyond prior auth into payment integrity, reducing single-product risk.
What buyers should weigh
- It sells to health plans, not providers; a provider organization only encounters Cohere through a payer that has adopted it.
- Much of its track record is concentrated in the Humana relationship, so plans of smaller size should ask for comparable references.
- Delegated UM and clinical policy alignment make implementations substantial projects with real compliance and integration work, not a light SaaS install.
Named customers
Humana · Geisinger Health Plan · Medical Mutual of Ohio
Integrations
Infinx
AI plus specialists for prior auth and patient access
- Founded
- 2012
- HQ
- San Jose, CA
- Stage
- Growth (KKR minority stake 2024)
- Raised
- $186M reported
What it does
- AI prior authorization determination, submission, and status tracking
- Eligibility verification and benefits checks in one platform
- Patient pay estimates before service
- Certified specialists work exceptions automation cannot resolve
- AR recovery and denial management services
Where it's strong
- The AI-plus-human model delivers completed authorizations, not just software your staff still has to work.
- Deep roots in high-volume prior auth specialties like radiology, labs, and cardiology.
- Trusted by more than 900 provider organizations, with KKR and Norwest backing.
What buyers should weigh
- Part of the value is outsourced labor, so compare its per-transaction economics against pure software options.
- Named customer references are rare in public materials; case studies are anonymized.
- Broad service catalog means implementation scope needs careful definition up front.
Integrations
Compare against the rest of Prior Authorization
Deciding between these two?
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