M&A: Cohere Health Acquires ZignaAI to Transform Payment Integrity

What You Should Know:

– Cohere Health, a leader in clinical intelligence solutions, has acquired ZignaAI and launched a new Payment Integrity (PI) Suite, which is anchored by Cohere Validate™. Financial details of the acquisition were not disclosed.

– Cohere Health’s approach is designed to provide transparency, accuracy, and control to claims payments through clinical intelligence. The new solution is already delivering faster payments, 30% efficiency gains, and 8-9x ROI to health plans.

ZignaAI Background

Founded in 2020, ZignaAI specializes in AI-driven payment integrity and revenue optimization solutions. Its flagship technology uses natural language processing (NLP) and machine learning with clinical insights to automate coding and clinical validation for health plans. Lalithya Yerramilli, SVP of payment solutions for Cohere Health and founder of ZignaAI, noted that ZignaAI’s mission has always been to make payment integrity reviews “smarter and more effective through the combination of advanced AI and coding and clinical expertise”.

Acquisition Impact

The acquisition allows Cohere Health to launch its new PI Suite, which addresses longstanding payment integrity challenges. Historically, payment integrity has been dominated by legacy vendors with “black box” algorithms that lack transparency and often strain payer-provider relationships. The Cohere Health PI Suite addresses these issues by shifting post-payment reviews upstream and improving collaboration. This allows health plans to catch errors before claims are paid, which reduces financial waste and provider friction. Providers benefit from faster payments and improved transparency, while plans gain clearer insights into the root causes of billing and coding errors.

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