Prior Authorization

Banjo Health streamlines the prior authorization process for health plans and pharmacy benefit managers.

Availity Essentials is a healthcare provider portal offering functionalities like eligibility and benefits checking , claims processing, remittance advice, provider information management, prior authorization and referral management.

Basys.ai is an AI-powered platform that streamlines prior authorization (PA) for health plans using GenAI for policy encoding and request processing.

Change Healthcare's Clearance Authorization software is a comprehensive solution designed to streamline prior authorization workflows in healthcare settings. It automates the process of verifying if pre-authorizations are required and on file, directly submitting requests to integrated payers.

Co:Helm is a generative AI platform for payer organizations, providing a co-pilot dashboard to empower UM nurses to get all of the right data summarized and presented so they can make the right decision faster.

Cohere Unify Platform helps health plans to streamline the prior authorization process using automation and AI.

CoverMyMeds helps automate prior authorization for medications, connecting healthcare networks to improve patient medication access.

Develop Health is an AI-enabled eligibility checking and prior authorization platform for medication that automatically calls payers to get benefits details, verifies clinical documentation against plan criteria, and automates form-filling across payer portals for faster authorization.

Ethermed is an AI-enabled prior authorization solution that helps determine authorization status, pulls clinical documentation, and automatically fills and submits requests for providers.

Experian Health's Prior Authorization Software is designed to automate the management of prior authorizations for healthcare providers, streamlining the process by handling inquiries and submissions automatically. It connects to a comprehensive database that regularly updates with national and local payer requirements, ensuring that users have access to the most current information.

Fairway Health is an AI assistant designed for health insurers to expedite the prior authorization process for patient treatments. The platform uses large language models (LLMs) to analyze extensive and complex medical records, determining patient eligibility for specific treatments.

FastAuth is a prior authorization platform that helps automate patient insurance eligibility and approval.

Latent uses AI to streamline specialty pharmacy and infusion prior authorization for hospitals and clinics.

Myndshft helps automate prior authorizations for acute and post-acute services, imaging labs, and diagnostics and genomics labs. The product uses a library of payer rules and an AI-enabled system that updates the workflow and rules engines based on previous prior authorization requests.

Rhyme Health streamlines prior authorization by connecting EHR systems and insurance carriers for faster submission and approval.

SamaCare is prior authorization platform primarily for buy-and-bill drugs, but can also be used for imaging and select procedures. The platform automates form-filling in payer portals, schedules reminders and auto-renewals, and identifies actions to speed up authorizations and reduce denials.

Silna uses AI to streamline prior authorizations, benefits and eligibility checks for therapists.