Clean ClAImsFirst Pass

Cohere Health vs Silna Health

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 HealthSilna Health
Pricing model

Enterprise contract (custom) · scoped by UM volume and model

Not published · Quote-based

Speed to go live

deep payer UM integration, multi-month program

Share data files; Silna handles setup

Automation model

Software platform · AI-assisted utilization management decisioning

Autonomous agents · AI runs benefit checks and auths

Built for

Payers

Small practices, Mid-size groups

Security posture

HITRUST, HIPAA

SOC 2 Type II, HIPAA

Company maturity

7 yrs (est. 2019)

3 yrs (est. 2023)

Financial backing

$200M · Series C

$27M · Series A

Named customers

3 named

None public

Published results

Specific numbers public

Specific numbers public

Documented integrations

3 listed

None documented

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 Silna if you run a therapy or specialty practice (ABA, PT/OT, behavioral) and want benefit checks and prior auths done for you within weeks of signing.

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

Rhyme network for provider-side connectivityHealth plan UM and claims systemsFHIR-based APIs supporting CMS-0057 compliance
Full Cohere Health profile →

Silna Health

Prior auth and benefits automation for therapy providers

Founded
2023
HQ
New York, NY
Stage
Series A
Raised
$27M

What it does

  • Automates benefit checks and eligibility verification before visits
  • Prepares, submits, and tracks prior authorization requests
  • Monitors authorizations and flags expirations and renewals
  • Covers 1,000+ payers across all 50 states
  • Sits alongside existing EHR and practice management systems
  • Built for ABA, PT/OT, speech, psychiatry, and other therapy specialties

Where it's strong

  • Purpose-built for therapy and specialty providers like ABA, where prior auth volume is the core operational pain.
  • Fast deployment because it sits alongside your stack rather than requiring deep EHR integration.
  • Strong reported results: insurance verification cut from 30 minutes to 30 seconds and approvals in hours with a claimed 99.8% success rate.

What buyers should weigh

  • Young company (founded 2023) with a short track record and no large publicly named customers.
  • Narrow front-end focus: it handles benefits and auth, not claims, denials, or the rest of the revenue cycle.
  • The no-integration approach means data lives in a separate staff-facing tool rather than flowing into your EHR automatically.
Full Silna Health profile →

Compare against the rest of Prior Authorization

Deciding between these two?

First Pass tracks Prior Authorization every week: funding, launches, and what changed since this page was written.