Infinitus is best when the missing fact is on a phone call to a payer or pharmacy. Cohere Health is best when the buyer is a health plan and the job is the authorization decision. For post claim submission operations, check out the Substrate Claim Status Agent.
At a glance
Infinitus
Cohere Health
Primary role
Voice agents for payer and pharmacy calls
Utilization management for health plans
Best buyer
Specialty providers, health systems, and life-sciences access teams
Health plans running delegated or in-house UM
How it reaches the payer
Outbound call, IVR, then a payer representative
Plan workflow. Providers can submit through Cohere APIs and Da Vinci CRD, DTR, and PAS
Claim status and denials
FastTrack claims follow-up keeps a person on the line after IVR. Notes can transfer to the customer system.
Not a provider claim-status product. Plan reviewers reuse the clinical record for appeals.
Prior authorization
Agents collect requirements and status after your team submits. Results return by API or the Infinitus portal.
Decisions against plan policy, NCDs, LCDs, and other guidelines. Cohere states 85% of authorizations approve in real time, depending on specialty.
Where Infinitus wins
- Electronic benefit checks and 278 transactions did not solve the problem
- Specialty medication access, including plan, network, and pharmacy details on one call
- A packaged call flow, rather than a phone tree your team scripts
Where Cohere Health wins
- When you're seeking authorization decisions from health plans
- Clinical review that reads records against digitized medical policy
- The same plan context can carry into appeals review, care management, and quality
Also consider Substrate
Substrate ARC is an agentic denial and reconciliation platform for provider groups, hospitals, and health systems. Substrate combines all your systems and data sources across clearinghouses, payer portals, EMRs, lockboxes and more, to comprehensively support your billing team and enable you to work every single denial. Consider Substrate if:
- You need end-to-end denial management, from triage through remediation, and appeal filing, not just phone dispositions
- Your payer mix is portal-heavy (Medicare, Medicaid MCOs, specialty commercial)
- You want structured PM writeback and audit trails across status, appeals, and posting
- You prefer agentic automation over manual execution or offshoring and outsourcing (Substrate is listed in the Anthropic Connector Directory and publishes a public claim-status MCP.)
- You want to keep billing in house but make it fast and cost effective