Best Prior Authorization Software
Prior authorization software assists healthcare providers and health insurance companies in the medical care authorization process. These insurance companies require healthcare clinicians and providers to receive preapproval for certain procedures, tests, or medications. The care plan must be evaluated to assess the medical necessity and cost-of-care ramifications before authorization. If the provider fails to get prior authorization, the insurer will not cover the cost of treatment, and the patient may have to bear the cost.
The healthcare provider is usually responsible for initiating prior authorization by submitting a request form to a patient’s insurance provider. This helps determine if prior approval is required for a given procedure and to submit the actual prior authorization paperwork to the insurance company for review and approval. Obtaining prior authorization is an administrative burden for any medical practice, and this software helps streamline the process.
Prior authorization software enables EHR software or patient relationship management (PRM) software to automatically determine if prior approval is required, electronically submit the prior authorization directly to the insurance company, and actively monitor the status of the submission. Prior authorization software can be paired with patient intake software and revenue cycle management software.
To qualify for inclusion in the Prior Authorization category, a product must:
Best Prior Authorization Software At A Glance
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- Overview
- Seller Details
Silna Health automates front-end RCM for healthcare providers, so care can start in hours, not weeks. From prior authorizations to benefit checks, insurance monitoring, and discovery, our AI-powered C
- Medical Practice
- Mental Health Care
- 75% Small-Business
- 20% Mid-Market
- Overview
- Seller Details
Valer’s technology speeds and simplifies prior authorization and referral management by automating submissions, status checking, verification, reporting, and EHR synchronization across all your health
- Hospital & Health Care
- 67% Enterprise
- 25% Mid-Market
172 Twitter followers
- Overview
- Seller Details
Integrated, customizable, ONC-certified clinical management and practice management software for healthcare providers and care organizations. Founded in 1999 and headquartered in Maryland, RXNT's s
- Hospital & Health Care
- Medical Practice
- 62% Small-Business
- 32% Mid-Market
- Overview
- Seller Details
Myndshft is the only fully automated end-to-end prior authorization platform, designed to address the needs of providers and payers by delivering Collective Healthcare Intelligence™: real-time benefit
- 60% Small-Business
- 40% Mid-Market
384 Twitter followers
- Overview
- Pros and Cons
- Seller Details
Infinitus AI agents provide end-to-end automation of payor, patient, and provider interactions that have traditionally required a phone call. They help automate, expedite, and simplify the time-consum
- 75% Mid-Market
- 25% Small-Business
751 Twitter followers
- Overview
- Seller Details
CoverMyMeds is a web-based provider of Prior Authorization (PA) support for physicians and pharmacists.
- Hospital & Health Care
- Pharmaceuticals
- 50% Small-Business
- 25% Mid-Market
2,682 Twitter followers
- Overview
- Seller Details
Service Center by Office Ally is a trusted Revenue Cycle Management and patient payments platform used by more than 80,000 healthcare providers and health services organizations, which process more th
- Mental Health Care
- Health, Wellness and Fitness
- 91% Small-Business
- 6% Mid-Market
659 Twitter followers
- Overview
- Seller Details
eClaimStatus is a Health insurance eligibility verification software that is easy to Use, comes with zero setup or maintenance hassles ,assures real-time , eligibility verification from 700+ payers, f
- 78% Small-Business
- 22% Mid-Market
6 Twitter followers
- Overview
- Seller Details
EHR 24/7 by Office Ally is a trusted electronic health record system used by more than 20,000 users. Its comprehensive patient charting and document management, real-time patient information, and cust
- 80% Small-Business
- 60% Mid-Market
659 Twitter followers
- Overview
- Seller Details
Waystar provides market-leading technology that simplifies and unifies the revenue cycle. Their cloud-based platform streamlines workflows and improves financials for healthcare providers of all kinds
- Billing Manager
- Office Manager
- Hospital & Health Care
- Medical Practice
- 61% Small-Business
- 32% Mid-Market
2,040 Twitter followers
- Overview
- Seller Details
AccuReg offers a full suite of all critical front-end RCM process solutions that hospital Patient Access departments need.
403 Twitter followers
- Overview
- Seller Details
Anterior is an AI-driven platform designed to streamline health plan operations by automating complex clinical tasks such as prior authorization, case management, and payment integrity. Developed by c
- Overview
- Seller Details
Authorization Manager by AccuReg is a comprehensive solution designed to streamline the prior authorization process for healthcare providers. By automating traditionally manual tasks, it reduces admin
403 Twitter followers
- Overview
- Seller Details
Azalea provides an electronic health record (EHR) platform, practice management (PM), revenue cycle management (RCM) and telehealth solutions for ambulatory and hospital care settings. Designed for ef
- Hospital & Health Care
- Medical Practice
- 75% Small-Business
- 25% Mid-Market
516 Twitter followers
- Overview
- Seller Details
basys.ai is Harvard-based company using generative AI to streamline prior authorization and utilization management for health plans.