Prior Authorization

84 tools

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

Rising in Prior Authorization

SamaCare

Practice Management & Scheduling

SamaCare is an AI-native platform that streamlines medical benefit prior authorization for specialty practices, improving approval rates and reducing time to resolution.

Silna Health

General Productivity (AI Assistants)

Silna Health is an AI-powered care readiness platform that automates prior authorizations, benefit checks, and insurance monitoring to streamline administrative processes for healthcare providers.

Custom / enterprise

HealOS Prior Authorization

HealOS

Prior Authorization

HealOS Prior Authorization automates the entire prior authorization workflow for healthcare providers using AI to extract data, submit requests, track approvals, and manage appeals, aiming to speed up approvals, reduce denials, and eliminate administrative bottlenecks.

Staffingly Prior Authorization

Staffingly, Inc.

Documentation & Scribing

Staffingly provides AI-assisted automation and virtual assistants for healthcare practices, specializing in prior authorization, insurance verification, and revenue cycle management.

Starting at $399 per week per fte

57 companies also tagged with Prior Authorization →

Prior Authorization tools, by specialty

Internal Medicine (63) Family Medicine (60) Hospital Medicine (42) 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)

LiveAuth™ Network

Rhyme (formerly PriorAuthNow)

Prior Authorization

Rhyme's LiveAuth™ Network is an AI-powered platform that connects providers and payers to streamline prior authorization processes, enabling real-time, automated decision-making and eliminating manual efforts for healthcare providers.

Contact for pricing

LucasAI

General Productivity (AI Assistants)

LucasAI Prior AuthAI is an AI-powered solution designed to automate and streamline the prior authorization process for healthcare providers, reducing administrative burden and improving approval times.

Starts at $39.99/month

MedCare MSO AI RCM Solutions

MedCare MSO

Documentation & Scribing

MedCare MSO provides AI-powered Revenue Cycle Management solutions including medical billing, coding, and rule engines to optimize financial processes for healthcare practices.

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.

Myndshft

General Productivity (AI Assistants)

Myndshft is a unified platform that automates both medical and pharmacy prior authorizations using generative AI and machine learning to speed time to therapy and reduce administrative burden.

Tier-based subscription software-as-a-service (saas) model, dependent on monthly patient transaction volume. pricing is not publicly disclosed; contact sales for a quote.

Nanonets Health AI Agents

Nanonets Health

Medical Billing & RCM

Nanonets Health AI Agents automate front-end revenue cycle management processes like patient intake, eligibility verification, prior authorization, and billing to reduce denials and optimize administrative time.

Consumption-based model, pay per workflow block execution

No Barrier

Medical Billing & RCM

No Barrier is an AI-powered tool by AI Agent (Elion.ai) that automates and streamlines the prior authorization process for healthcare providers.

Predictable annual pricing, not per-minute.

NYX Health AI Prior Authorization Solution

NYX Health

Documentation & Scribing

NYX Health provides an AI-powered prior authorization solution, AVA, that integrates with existing EHRs to streamline the authorization process, reduce denials, and improve revenue cycle performance for healthcare providers.

OmniMD Pre-Authorization

OmniMD

EMR / EHR Systems

OmniMD's Pre-Authorization services aim to ease the process of ensuring insurance coverage for medical procedures, automating insurance verifications, handling approvals, and ensuring compliance with payer requirements. This AI-driven platform is designed to reduce prior authorization turnaround times from an average of 10 business days to approximately 2 hours for eligible procedures. It integrates with EHR, RCM, PMS, and RPM systems, tracking every request from submission to resolution with complete audit trails and role-based access controls.

Subscription-based

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

Patient Access Curator™

Experian Health

Medical Billing & RCM

Patient Access Curator™ is an AI-powered solution from Experian Health that helps prevent claim denials by validating demographics, eligibility, insurance discovery, coordination of benefits (COB), and MBI in seconds, integrating directly into existing workflows and host systems like Epic.

Contact for pricing

PayZen

Patient Engagement & Education

PayZen provides AI-powered patient financing solutions that offer personalized, interest-free payment plans to increase patient payments and satisfaction for healthcare providers.

Penguin AI

Elion Health

Medical Billing & RCM

Penguin AI is an AI platform used in provider and payer revenue cycle and prior authorization workflows. It provides task-specific digital workers and pre-trained clinical language models that process prior authorization requests, scrub claims and support billing review, and triage denials while drafting appeals.

Penguin AI (by Elion)

Elion

Medical Billing & RCM

Subscription-based

Plena

Plena Health

Clinical Decision Support & Reference

Plena is an AI-powered clinical intelligence platform designed to automate administrative and clinical tasks, enhancing efficiency and patient care.

Contact vendor for pricing.