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 is a healthcare technology solution that offers best-in-class front-end RCM solutions for healthcare providers across the country. It works with every payor in the country and handles all
- Medical Practice
- Mental Health Care
- 78% Small-Business
- 22% 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
168 Twitter followers
- Overview
- Pros and Cons
- 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
382 Twitter followers
- Overview
- Pros and Cons
- Seller Details
Infinitus is the conversational AI solution for health care. Through a combination of NLP and state-of-the-art AI models, Infinitus automates routine calls between providers, payers, pharmacies, and m
- 100% Small-Business
657 Twitter followers
- Overview
- Seller Details
CoverMyMeds is a web-based provider of Prior Authorization (PA) support for physicians and pharmacists.
- Hospital & Health Care
- Pharmaceuticals
- 47% Small-Business
- 27% Mid-Market
2,723 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
- Pros and Cons
- 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
650 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
- Health, Wellness and Fitness
- Medical Practice
- 90% Small-Business
- 6% Mid-Market
650 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
2,038 Twitter followers
- Overview
- Seller Details
AccuReg offers a full suite of all critical front-end RCM process solutions that hospital Patient Access departments need.
408 Twitter followers
- Overview
- Seller Details
408 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
519 Twitter followers
- Overview
- Seller Details
basys.ai is Harvard-based company using generative AI to streamline prior authorization and utilization management for health plans.
- Overview
- Seller Details
Change Healthcare (Nasdaq: CHNG) is a leading healthcare technology company, focused on insights, innovation and accelerating the transformation of the U.S. healthcare system through the power of the
36,910 Twitter followers
