Best Prior Authorization Software Companies

Waystar specializes in healthcare revenue cycle management solutions within the healthcare technology sector. The company offers a software platform that supports financial clearance, revenue capture, claim management, and payment management for healthcare providers. Waystar's solutions aim to improve the financial performance of healthcare organizations by using AI and advanced automation to streamline processes and assist with patient financial care. Waystar was formerly known as Navicure. It was founded in 2000 and is based in Louisville, Kentucky.

Cohere Health serves as a clinical intelligence company that focuses on utilization management and prior authorization in the healthcare sector. The company provides solutions for the prior authorization process, which include intelligent prior authorization, compliance with healthcare regulations, and a platform for health plans to manage their utilization management operations. It was founded in 2019 and is based in Boston, Massachusetts.

Infinitus Systems engages in healthcare artificial intelligence (AI) communication within the healthcare industry. It offers a digital assistant named Eva that automates routine calls for tasks such as benefit verification, prior authorization, and pharmacy follow-ups, traditionally done manually. Infinitus primarily serves ambulatory surgery centers, health systems, labs and diagnostics, pharmaceutical patient support, and specialty pharmacies. It was founded in 2019 and is based in San Francisco, California.

Thoughtful AI provides AI-powered revenue cycle management (RCM) automation for the healthcare sector. The company has AI agents that automate key RCM tasks such as eligibility verification, prior authorization, coding and notes review, claims management, denials management, and payment posting. These AI agents operate within existing RCM tech stacks. It was founded in 2020 and is based in Austin, Texas.

AidIn provides healthcare technology, focusing on referral management and patient outcome improvement. The company offers a digital platform that assists with discharge planning and prior authorization processes, and aims to reduce hospital readmissions. AidIn serves hospitals, healthcare systems, post-acute care providers, and case managers within the healthcare sector. It was founded in 2011 and is based in New York, New York.

AKASA provides generative AI (artificial intelligence) solutions for the healthcare revenue cycle, concentrating on financial processes within the healthcare sector. The company's offerings include automation and optimization of prior authorization, medical coding, claim status updates, and claim attachment processes, powered by generative AI trained on clinical and financial data. It serves hospitals and health systems, with a goal of improving operational efficiency and financial outcomes. AKASA was formerly known as Alpha Health. It was founded in 2018 and is based in San Francisco, California.

Banjo Health focuses on prior authorization automation within the healthcare sector. Its main offerings include a workflow platform that utilizes artificial intelligence to streamline the prior authorization process for medical and pharmacy benefits. The platform features decision trees for responses to prior authorization requests and tools for healthcare professionals to manage clinical criteria. Banjo Health serves health plans and pharmacy benefit managers. It was founded in 2019 and is based in Washington, District of Columbia.

Itiliti Health is involved in automating the prior authorization process within the healthcare sector. The company provides products for medical policy management, prior authorization routing, and clinical decision support. Itiliti Health serves payers and providers in the healthcare industry. It was founded in 2019 and is based in Eden Prairie, Minnesota.

Notable operates as a company focused on automating healthcare operations through its artificial intelligence (AI) platform. The company offers a suite of services designed to streamline administrative workflows, including registration, scheduling, and care management, by utilizing intelligent agents and customizable automation tools. Notable primarily serves the healthcare industry, providing solutions that aim to improve patient care. It was founded in 2017 and is based in San Mateo, California.

SamaCare is a healthcare technology company that provides a cloud-based platform for healthcare providers to submit, track, and manage prior authorizations with various payers and for different medications. The platform is designed to integrate with electronic medical record (EMR) systems and offers features such as submission tracking and expiration reminders. It was founded in 2018 and is based in San Francisco, California.

Silna Health operates as a healthcare services company. It specializes in streamlining patient care processes for healthcare providers. The company offers comprehensive services that manage prior authorizations, benefits, and eligibility checks to facilitate patient care. Silna Health primarily serves the healthcare industry, including sectors such as physical therapy, speech therapy, occupational therapy, and behavioral health. It was founded in 2023 and is based in New York, New York.

Surescripts operates within the healthcare sector, offering services including electronic prescribing, clinical interoperability, and prior authorization automation. The company serves healthcare professionals and organizations, providing tools intended for patient care. It was founded in 2001 and is based in Arlington, Virginia.

Tennr operates as a company automating paperwork for healthcare practices within the healthcare industry. The company provides services that automate tasks such as scheduling and qualifying patient visits, allowing practices to manage their workflow. Tennr's solutions aim to reduce billing errors. It was founded in 2021 and is based in New York, New York.

Vim provides healthcare integration solutions within the health technology sector. The company offers a platform that integrates data, insights, and applications into electronic health record (EHR) workflows. It provides solutions to various sectors including value-based care, point-of-care services, ACOs, provider enablers, payers, providers, EHRs, and developers. Vim was formerly known as BookMD. It was founded in 2015 and is based in San Francisco, California.

VoiceCare AI focuses on healthcare administration tasks using voice AI technology. It provides services that handle routine conversations and tasks for healthcare companies, including benefit verification, prior authorization, claims management, and prescription support. It serves the healthcare industry and applies generative AI. It was founded in 2022 and is based in Sacramento, California.