AKASA Authorization Advisor is an AI-enabled prior authorization tool for streamlining the submission, tracking, and follow-up of medical authorization requests for procedures. It is integrated with Epic and Cerner, and focuses on health system-specific use cases.

AutonomizeAI's Prior Auth Copilot extracts and summarizes member authorization requests, links clinical data to internal sources, and assesses compliance with clinical guidelines. It generates decision summaries that help reduce administrative burdens and speed up approvals.

Infinitus offers an outbound AI phone platform to handle calls like benefit verification, prior authorization, and prescription follow-up. It automates data collection processes with accuracy, integrates with existing healthcare systems, and supports a variety of standardized call flows.

Silna Health focuses on helping specialty healthcare providers manage prior authorizations, benefits, and eligibility checks. It is designed for use in physical therapy, speech therapy, and behavioral health. Silna automates the authorization process using AI, provides regular benefit and eligibility checks, and sends reminders for expiring authorizations to prevent lapses in care.

Synthpop provides AI-enabled tooling for automating referral intake, handling incoming faxes, analyzing patient records to evaluate treatment eligibility, and transcribing patient conversations to optimize around payer guidelines for claims submission.

Develop Health is an AI-enabled eligibility checking and prior authorization platform for medication. It automates benefit verification, clinical eligibility checks, and prior authorization form completion, and automatically calls payers to get benefit details. By integrating patient insurance data and clinical history, the platform increases first-time approval rates and reduces delays in accessing medications.

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

Humata Health provides an AI-driven platform designed to automate the prior authorization process in healthcare. It integrates with EHRs and payer systems to streamline authorizations, using machine learning for intelligent document recommendations and one-click submissions. The platform prioritizes cases, monitors for changes, and automates status updates to improve efficiency and reduce manual work.

Latent Health uses generative AI to optimize healthcare operations, particularly in pharmacy workflows. The platform integrates with EHR systems using SMART on FHIR, providing functionalities like rapid patient data retrieval, AI-assisted 340B qualification, and automated prior authorizations.

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.

RISA Labs offers AI-powered automation solutions for managing prior authorizations in healthcare, focusing on reducing denial rates, administrative workload, and compliance risks. Its platform integrates with major EHR systems and utilizes advanced AI to optimize first-time submission success and streamline workflows. RISA’s tools include proactive denial prevention and real-time compliance monitoring, aimed at minimizing rejections and financial losses for both healthcare providers and payers.

SamaCare is a platform that simplifies prior authorizations for buy-and-bill drugs, imaging, and select procedures. It helps providers by managing forms, tracking statuses, and supporting communication with payers. It automates form recommendations, auto-fills information, and updates tracking with responses. SamaCare integrates with EHRs for patient information lookup and two-way synchronization, and supports faxes and payer portals. Built-in communication tools facilitate collaboration among revenue management and clinical staff, improving efficiency and reducing administrative tasks.

SparkChange Authorizations offers a solution for managing prior authorization. Key features include automated identification of required authorizations, correction of authorization discrepancies post-service, retroactive authorization handling, and continuous monitoring of denials for appeals. The platform also provides custom edits to prevent claims without proper authorizations from being processed.

Tandem is a prescription concierge service that uses AI to get patients their medications as quickly and cheaply as possible. It checks prescriptions against insurance and cash prices, along with coupons and financial assistance programs, to find the best price for the patient. If prior authorization is required, Tandem will work with the patient's doctor to handle it.

Thoughtful AI is an AI Revenue Cycle Automation platform that integrates with EHRs and practice management systems to automate tasks in eligibility verification, patient intake validation, claims processing, payment posting, with additional capabilities in coding, provider management, and revenue reporting.

Waystar's Prior Authorization platform uses intelligent automation to manage the entire authorization process. It automatically verifies, initiates, tracks status, and retrieves authorization details, integrating directly with major EHR systems. The platform automates patient referral status, handles unscheduled admissions, and generates necessary medical notices. It adapts to changing payer rules and is maintained by an in-house team of experts. AI is used to verify if authorization is required, gather data, send documentation, check status, and flag potential issues.