Cohere Health Brings Transparency to Health Plan Data Mining with Adaptive Claims Intelligence

New agentic AI offering delivers full visibility into why overpayments happen–enabling faster action, greater efficiency at scale, and continuous improvement

BOSTON, April 28, 2026 /PRNewswire/ -- Cohere Health®, the leader in clinical intelligence solutions for health plans, today announced the launch of Cohere Surface™, a fundamentally new approach to data mining that replaces opaque, manual, and vendor- and IT-dependent processes with a transparent claims intelligence solution, powered by agentic AI.

Health plans face significant operational hurdles in managing their data mining programs. In-house data mining operations suffer from long and laborious rule development timelines and maintenance cycles, requiring coordination between siloed functions. Service-led operations, built on contingency-based models, provide limited visibility into findings and profit from recurring errors. Legacy vendors aren't incentivized to improve data mining programs or surface new overpayment findings. Generic analytic tools lacking a native understanding of healthcare compound these challenges, piecing together fragmented data sources that fail to provide a complete picture of what is driving overpayments.

"For too long, health plans have relied on opaque, contingency-based offerings that limit visibility into what's driving overpayments and how to prevent them. The same issues surface repeatedly, with no path to building something better," said Lalithya Yerramilli, SVP of payment solutions at Cohere Health. "With Cohere Surface, we're delivering a transparent, efficient, and flexible solution that truly breaks the status quo–empowering health plans to understand the 'why' behind their data, own that institutional knowledge, and continuously evolve their data mining strategies."

Cohere Surface gives health plans the control and intelligence they need to scale and strengthen their data mining programs. Whether deployed in-house or via services, the solution provides full visibility into rule logic and overpayment patterns, including root causes. In-house teams accelerate their timelines by building and iterating on rules in hours–without IT dependency. Pre-configured rules meaningfully reduce set-up time, and automated monitoring ensures rules stay current as policies and other supporting documentation change. Agentic AI powers end-to-end workflows, with domain-specific AI agents that run rules continuously, process findings, and support rule maintenance with human oversight ensuring accuracy and compliance.

Cohere Surface also connects both structured and unstructured data–including claims, contracts, benefits, policies, and clinical documentation–to create a comprehensive data fabric. This unified foundation gives health plans a complete, transparent view of the information needed to accurately adjudicate claims, continuously refine rules, and make proactive, data-driven decisions. The result is a data mining program that doesn't just find what's wrong–it builds the foundation for a smarter, more resilient payment integrity operation over time.

Cohere Surface is available as a standalone solution and as part of Cohere Health's Payment Integrity Suite, which includes Cohere Validate™, Cohere Complete™ for PI, and Cohere Match™. For more information about Cohere Surface and how it modernizes data mining operations with advanced technology and transparency, visit https://www.coherehealth.com/payment-integrity/data-mining. Client outcomes may vary.

About Cohere Health
Cohere Health's clinical intelligence platform and agentic AI-powered solutions connect health plans' strategic goals and providers' needs, optimizing the speed, cost, and quality of care. With an enterprise approach that streamlines payer-provider decision-making across the care continuum–including policy, prior authorization, payment accuracy, and more–the company improves collaboration and reduces burden, resulting in 9x ROI and 94% provider satisfaction. Cohere Health is recognized on TIME's World's Top HealthTech Companies 2025 list, on the 2025 Inc. 5000 list, and by numerous industry analysts.

Media Contact
Brynn Spicher
anthonyBarnum Public Relations
[email protected]

SOURCE Cohere Health