Prior Authorization

83 tools

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

Rising in Prior Authorization

Solventum Revenue Integrity System

Solventum

Medical Billing & RCM

Solventum Revenue Integrity System uses AI and automation to optimize revenue cycle management, prevent revenue leakage, and improve billing accuracy for healthcare organizations.

Optum Digital Auth Complete

Optum

Prior Authorization

Optum Digital Auth Complete is an AI-powered solution that integrates with EHRs to automate and streamline the prior authorization process for providers, aiming to reduce manual tasks and accelerate approvals.

Contact sales

Inferscience

Documentation & Scribing

Inferscience HCC Assistant is an AI-powered tool designed to help healthcare providers and health plans optimize risk adjustment and HCC coding accuracy.

ModMed Scribe 2.0

ModMed

Documentation & Scribing

ModMed offers a suite of AI assistants, including ModMed Scribe, to automate administrative and clinical workflows, enhance documentation, and streamline practice operations for physicians.

57 companies also tagged with Prior Authorization →

Prior Authorization tools, by specialty

Internal Medicine (62) Family Medicine (59) Hospital Medicine (41) Pediatrics (7) General Surgery (6) Radiology (5) ophthalmology-ai (4) Cardiology (3) dental-ai (3) Gastroenterology (3) mental-health-ai (3) Orthopedics (3) primary-care (3) radiology-imaging-ai (3) Urology (3) Dermatology (2) dermatology-ai (2) endocrinology-metabolic-ai (2) gastroenterology-ai (2) neurology-ai (2) obstetrics-gynecology-ai (2) Oncology (2) oncology-ai (2) allergy (1) allergy-and-immunology (1) cardiology-ai (1) Critical Care (1) ear-nose-throat (1) Emergency Medicine (1) hepatology (1)

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

Daniel

Red Sky Health

Medical Billing & RCM

Daniel is an AI platform by Red Sky Health that automates the denial management process, analyzing denied claims, recommending corrections, and automating resubmission to recover lost revenue.

Droidal for Front-End Intake and Eligibility Automation

Droidal

Medical Billing & RCM

Droidal automates front-end intake and eligibility for healthcare, streamlining patient registration, insurance verification, and prior authorizations with AI.

Subscription

e4health

General Productivity (AI Assistants)

e4health utilizes AI-powered technology to enhance cost efficiency and accuracy in medical record custodian (MRC) management for healthcare finance.

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.

elsai Prior Authorization AI Agent

elsai

Prior Authorization

elsai orchestrates specialized AI agents to automate eligibility verification, prior authorization requirements, documentation completeness, and submission.

Contact for pricing

Ember (by Elion)

Elion

Medical Billing & RCM

Ember is an AI-powered revenue cycle management (RCM) platform for healthcare providers that automates medical coding, claims scrubbing, eligibility checks, prior authorization, and denial prevention/appeals. It integrates with EHRs/PMS systems to reduce denials, accelerate payments, and lessen administrative burden.

Tailored based on volume, scope, and use case.

Ember Denial Appeals & Prevention

Elion Health

Medical Billing & RCM

Ember AI uses machine learning to identify claims at risk of denial before submission and automates appeal workflows, including drafting evidence-based appeal letters.

Subscription-based

Entropy (by Elion)

Elion

Medical Billing & RCM

Entropy is an AI platform used in specialty healthcare operations to automate patient intake and revenue cycle workflows. It provides document classification and referral triage, verifies insurance eligibility, and submits and manages prior authorization requests and denial follow-up while supporting human-in-the-loop review for clinical accuracy.

Paid, with a free trial

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

Experian Health AI Advantage

Experian Health

Medical Billing & RCM

Experian Health AI Advantage uses AI and machine learning to predict and prevent denials, automate reviews, and improve front-end accuracy for faster reimbursement, ultimately strengthening financial performance for healthcare organizations.

Enterprise pricing model, not publicly disclosed.

FinThrive Revenue Optimization

FinThrive

Medical Billing & RCM

FinThrive Revenue Optimization uses AI to streamline healthcare revenue cycle management, automating tasks like prior authorizations, predicting cash flows, and preventing denials to improve financial performance for providers.

Contact for pricing

Flexbone

General Productivity (AI Assistants)

Flexbone.com is a domain name available for sale, managed by Grails.com, and does not currently represent an active AI tool or service for physicians.

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.

Forus

Patient Engagement & Education

Forus automates prior authorizations and medication access support for physicians, helping patients get prescribed medications quickly and seamlessly.

Free