Prior Authorization

42 tools

AI tools for prior authorization, medical billing, revenue cycle management, denial prevention, and claims processing automation.

Rising in Prior Authorization

CustomAI Studio for Revenue Cycle Management
CustomAI Studio
Medical Billing & RCM
CustomAI Studio offers AI revenue cycle management solutions that automate tasks between a completed visit and posted payment, including eligibility verification, prior authorization, charge capture, claim scrubbing, submission, ERA reconciliation, and denial management. They emphasize that clinicians and billers remain in the loop for all clinical or financial decisions, with the AI drafting, organizing, and surfacing information for human approval.
Custom pricing
Pre-Auth AI
Jade Global
Medical Billing & RCM
Jade Global's Pre-Auth AI solution automates prior authorization processes, aiming for 95% accuracy in claim submissions and a 50-60% reduction in process time, ultimately enhancing patient care and revenue cycle management.
Custom
Flexbone AI Denials Management
Flexbone AI
Medical Billing & RCM
Flexbone AI offers an AI-powered administrative automation platform designed to streamline healthcare contact center operations and revenue cycle management. Their AI agents automate tasks like prior authorization, insurance eligibility verification, referral coordination, patient intake, call routing, and denials management.
Authorizations
Experian Health
Medical Billing & RCM
Experian Health's Authorizations is an AI-guided online service that automates prior authorization inquiries and submissions, leveraging a real-time payer knowledgebase to reduce manual interventions, prevent denials, and accelerate reimbursement for healthcare providers.
Contact for details

36 companies also tagged with Prior Authorization →

Prior Authorization tools, by specialty

Internal Medicine (32) Family Medicine (30) Hospital Medicine (19) Radiology (5) Pediatrics (4) Cardiology (3) General Surgery (3) primary-care (3) Gastroenterology (2) Orthopedics (2) Urology (2) allergy-and-immunology (1) Critical Care (1) dental-ai (1) Dermatology (1) dermatology-ai (1) ear-nose-throat (1) Emergency Medicine (1) endocrinology-metabolic-ai (1) gastroenterology-ai (1) hepatology (1) Mental & Behavioral (1) mental-health-ai (1) neurology-ai (1) Neurosurgery (1) Obstetrics & Gynecology (1) obstetrics-gynecology-ai (1) Oncology (1) oncology-ai (1) ophthalmology-ai (1)
AGS AI
AGS Health
Medical Billing & RCM
AGS AI is an AI-based end-to-end revenue cycle management platform integrating AI, automation, and human expertise to enhance accuracy, efficiency, and productivity across the RCM lifecycle, including autonomous coding and intelligent authorization.
Contact for pricing
Asepha
Asepha
Pharmacology & Dosing AI
Asepha is an AI assistant for pharmacy that automates manual work, reduces delays in intake and prior authorization, and helps prevent medication errors.
Contact for pricing
Auth Accelerate
Waystar
Medical Billing & RCM
Waystar Auth Accelerate is an AI-powered solution for automating prior authorizations, streamlining financial clearance, and reducing claim denials to simplify healthcare payments for providers.
Contact for pricing
AuthAI
Availity
Prior Authorization
Availity AuthAI leverages transparent, analytical AI to provide real-time, policy-aligned prior authorization recommendations, accelerating the process for healthcare providers and health plans while ensuring compliance and reducing administrative burden.
Contact sales
Authorizations
Experian Health
Medical Billing & RCM
Experian Health's Authorizations is an AI-guided online service that automates prior authorization inquiries and submissions, leveraging a real-time payer knowledgebase to reduce manual interventions, prevent denials, and accelerate reimbursement for healthcare providers.
Contact for details
Banjo Health Platform
Banjo Health
Prior Authorization
Banjo Health offers an AI-powered, end-to-end platform designed by clinicians for health plans and PBMs to streamline prior authorization, appeals, and grievances workflows, reducing administrative burden and improving decision-making.
Contact for details
Bulwark Quality AI
Bulwark Health
Medical Billing & RCM
Bulwark Health provides AI-native Mid-RCM solutions for healthcare, focusing on revenue integrity, patient outcomes, and operational excellence through products like Quality AI, Risk Adjustment AI, CDI & Coding AI, and Appeals AI.
Contact for pricing
CognitiveHealth iCAN™
CognitiveHealth Technologies
Medical Billing & RCM
CognitiveHealth's iCAN™ platform leverages advanced AI technology to revolutionize eligibility verification and denial management processes, addressing some of the most persistent challenges in medical billing.
Contact for pricing
Cohere Health Platform
Cohere Health
Medical Billing & RCM
Cohere Health provides an AI-powered clinical intelligence platform that streamlines prior authorization and payment integrity for health plans and providers, driving efficiency, improving care access, and optimizing financial performance.
Contact for pricing
Collectly
Collectly
Patient Engagement & Education
Collectly modernizes the patient financial experience through AI-powered automation of billing, payments, and communication.
CombineHealth
CombineHealth
Medical Billing & RCM
CombineHealth offers an end-to-end AI revenue cycle automation platform that leverages proprietary agentic and generative AI, trained on billions of medical records, to streamline eligibility checks, medical coding, CDI, billing, denials, and AR workflows for healthcare providers, aiming for zero revenue leakage.
Contact for pricing
CuraQt
CuraQt
Medical Billing & RCM
CuraQt is an AI-powered prior authorization platform that automates preparation, submission, tracking, and denial management for healthcare providers, aiming for 2026 compliance.
Paid
CustomAI Studio for Revenue Cycle Management
CustomAI Studio
Medical Billing & RCM
CustomAI Studio offers AI revenue cycle management solutions that automate tasks between a completed visit and posted payment, including eligibility verification, prior authorization, charge capture, claim scrubbing, submission, ERA reconciliation, and denial management. They emphasize that clinicians and billers remain in the loop for all clinical or financial decisions, with the AI drafting, organizing, and surfacing information for human approval.
Custom pricing
EasyPA.ai
EasyPA.ai
Prior Authorization
EasyPA.ai is an AI-powered prior authorization platform that automates the PA process for medical practices. It connects to 900+ payers and integrates with 10+ EHR systems including Epic, Cerner, and athenahealth.
1
EthermedAI
Ethermed
Prior Authorization
EthermedAI is an AI-driven platform that automates prior authorization workflows, enhancing efficiency and reducing manual processes in healthcare settings by integrating seamlessly with existing EHRs.
Contact for pricing
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