AI Prior Authorization for Providers
These are tools that use AI to streamline the provider end of the prior authorization process. Functions usually include:
• Identification of prior authorization requirements and processes
• Automatic population of prior authorization forms
• Submission of prior authorization requests
• Reporting and checks on prior authorization status
• Support with appealing prior auth denials
Prior authorization vendors vary meaningfully in their service coverage, with some specialized for pharmacy and others focused on certain types of medical services.
9 Results
AKASA
AKASA Authorization Advisor
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.
Synthpop
Synthpop
Synthpop provides AI-enabled tooling for automating referral intake, analyzing patient records to evaluate treatment eligibility, and transcribing patient conversations to optimize around payer guidelines for claims submission.
Develop Health
Develop Health
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
Ethermed
Ethermed is an AI-enabled prior authorization solution that helps determine authorization status, pulls clinical documentation, and automatically fills and submits requests for providers.
Latent
Latent
Latent uses AI to streamline specialty pharmacy and infusion prior authorization for hospitals and clinics.
Myndshft
Myndshft
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.
SamaCare
SamaCare
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 Health
Silna
Silna uses AI to streamline prior authorizations, benefits and eligibility checks for therapists.
Tandem
Tandem
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.
