Top 30 Best Prior Authorization Automation Solutions

Silna Health

Silna Health is an AI-powered platform that automates every aspect of the prior authorization lifecycle, from submission to approval follow-ups. It’s best for healthcare organizations that want full-service automation for faster approvals.

Key Features:

AI-powered eligibility checks and submission routing
Real-time status updates and reminders
Integrated with EHR workflows

Pros & Cons:

Pros: Reduces manual tasks; improves approval turnaround
Cons: Requires EHR integration for full functionality

Pricing: Custom pricing based on practice size

Expert Commentary: “Silna’s AI-first automation drastically reduces delays in prior auth workflows, especially for high-volume clinics.” — Dr. Lauren Matthews, Director of Clinical Operations

Demo Video: Watch how Silna Health streamlines prior authorizations

Valer

Valer is a modern prior authorization tool that consolidates all auth-related tasks into one dashboard, helping teams track, manage, and complete requests faster. Best for clinics that want centralized PA management.

Key Features:

Auto-filled payer forms
Status tracking and in-app messaging
Seamless sync with major EHRs

Pros & Cons:

Pros: Excellent UI; supports all payer forms
Cons: Initial onboarding can take time

Pricing: Available upon request

Expert Commentary: “Valer’s centralized system gives practices full visibility and control over every auth request.” — Michael Ross, RCM Strategy Lead

Demo Video: See Valer in action

RXNT

RXNT offers ePA capabilities within its suite of health IT tools, streamlining authorizations directly from the provider’s workflow. Best for small practices using integrated EHRs.

Key Features:

Built-in electronic prior auth submission
Works within prescribing tools
Fully certified EHR integration

Pros & Cons:

Pros: Easy to use; no third-party platform required
Cons: Limited to RXNT ecosystem

Pricing: Custom quotes based on modules

Expert Commentary: “RXNT’s built-in prior auth feature makes it seamless for providers already using their ecosystem.” — Jessica Taylor, Medical Practice Consultant

Demo Video: Explore RXNT’s prior auth automation

Myndshft

Myndshft leverages AI and blockchain to verify eligibility, check benefits, and automate auth workflows. Ideal for enterprise-level organizations.

Key Features:

Real-time payer intelligence
AI-driven form completion
End-to-end pharmacy & medical PA coverage

Pros & Cons:

Pros: Scales well; reduces errors and rework
Cons: Requires technical implementation team

Pricing: Custom enterprise pricing

Expert Commentary: “Myndshft is one of the most advanced platforms for payer data and auth automation at scale.” — Brian Kendall, VP of Revenue Integrity

Demo Video: Learn about Myndshft automation

CoverMyMeds

CoverMyMeds is widely known for pharmacy prior authorizations, offering a powerful ePA solution embedded into prescribers’ workflows.

Key Features:

Instant ePA integration with EHRs and pharmacies
Automated patient and provider notifications
Status and denial tracking

Pros & Cons:

Pros: Supports over 700,000 providers; widely adopted
Cons: Primarily focused on pharmacy rather than medical PAs

Pricing: Freemium model with enterprise upgrades

Expert Commentary: “CoverMyMeds reduces the medication access timeline drastically, particularly for specialty drugs.” — Dr. Nora Hill, Chief Pharmacist

Demo Video: See how CoverMyMeds works

6. Waystar

Waystar’s Authorization Platform automates prior authorization workflows, helping healthcare organizations reduce denials and improve productivity.

Key Features:

Real-time approval status
Automatic status updates
Seamless integration with EHR systems

Pros & Cons:

Pros: Improves staff efficiency and reduces manual errors
Cons: May require initial onboarding and training for new users

Pricing:
Custom pricing available upon request from Waystar’s sales team.

Expert Commentary:
“Waystar’s automation tools have significantly improved our authorization processes.” – Dr. Emily Thompson, Healthcare Administrator

7. Experian Health

Experian Health’s prior authorization software validates requests in real-time and checks payer criteria, reducing administrative errors and improving approval rates.

Key Features:

Automated submission and tracking
Real-time eligibility verification
Reduces claim rejections and delays

Pros & Cons:

Pros: Enhances accuracy and speeds up the prior auth process
Cons: Integration complexity may vary depending on your current systems

Pricing:
Available on request via Experian Health’s official contact form.

Expert Commentary:
“Experian’s solution has streamlined our prior authorization process, leading to fewer denials.” – John Davis, Revenue Cycle Manager

8. Availity

Availity uses AI-powered automation to streamline prior authorization, allowing healthcare providers to minimize manual steps and improve payer collaboration.

Key Features:

AI-driven submission and tracking
Real-time eligibility checks
Compatibility with multiple payer systems

Pros & Cons:

Pros: Reduces turnaround time; strengthens provider-payer communication
Cons: Initial configuration may require time and technical resources

Pricing:
Customized plans are available based on organization size and needs.

Expert Commentary:
“Availity’s AI capabilities have significantly reduced our authorization turnaround times.” – Sarah Lee, Clinical Operations Director

9. eClaimStatus

eClaimStatus offers a simple yet powerful platform for automating prior authorizations, helping practices get faster approvals and reduce human error.

Key Features:

Real-time verification of coverage
Alerts for authorization expirations
Insightful dashboards and reports

Pros & Cons:

Pros: Easy to use and intuitive interface
Cons: Limited advanced features compared to enterprise-level platforms

Pricing:
Pricing is flexible and based on the number of providers and claims volume.

Expert Commentary:
“eClaimStatus helps our team stay ahead of authorizations with minimal effort.” – Kevin Brooks, Medical Billing Lead

10. Verata Health (Olive AI)

Verata Health, now part of Olive AI, streamlines prior authorization with machine learning and real-time decision-making to improve speed and efficiency.

Key Features:

AI-powered submission and status tracking
Integration with major EMRs
Prioritization of urgent cases

Pros & Cons:

Pros: Highly advanced AI engine; excellent for large systems
Cons: May be overpowered for small practices or clinics

Pricing:
Quote-based pricing available from Olive AI’s team.

Expert Commentary:
“Olive AI’s acquisition of Verata brought next-level intelligence to our prior auth workflow.” – Lisa Montgomery, Director of Health IT

11. Orbit Healthcare

Orbit Healthcare offers an AI-powered prior authorization automation workflow that saves providers an average of 60% on existing costs by replacing manual processes.

Key Features:

Automates up to 82% of prior authorization tasks
Manages 1.3 million rules across 300+ health plans
Real-time eligibility verification and submission

Pros & Cons:

Pros: Significant cost savings; extensive payer rule management
Cons: Implementation may require integration with existing systems

Pricing:
Customized pricing based on organizational needs; contact Orbit Healthcare for details.

Expert Commentary:
“Orbit’s automation has drastically reduced our administrative workload, allowing staff to focus more on patient care.” – Dr. Linda Martinez, Chief Medical Officer

12. Infinitus

Infinitus automates the entire phone call process required for prior authorization follow-up tasks, reducing the need for manual calls to payers.

Key Features:

Automates phone-based prior authorization follow-ups
Integrates with existing workflows
Provides comprehensive status updates

Pros & Cons:

Pros: Eliminates manual call tasks; improves efficiency
Cons: May require initial setup and training

Pricing:
Contact Infinitus for a tailored pricing plan.

Expert Commentary:
“Infinitus has transformed our prior authorization process by removing the need for time-consuming phone calls.” – Sarah Johnson, Operations Manager

13. CoverMyMeds

CoverMyMeds simplifies the process of submitting prior authorizations to insurance companies, offering a user-friendly platform for providers.

Key Features:

Streamlined prior authorization submissions
Real-time status tracking
Integration with EHR systems

Pros & Cons:

Pros: User-friendly interface; broad payer network
Cons: Limited customization options

Pricing:
Free for providers; additional services may incur costs.

Expert Commentary:
“CoverMyMeds has made our prior authorization process more straightforward and less time-consuming.” – Dr. Michael Lee, Family Physician

Demo Video:
DrChrono CoverMyMeds (ePA) – Electronic Prior Authorization

14. R1 RCM

R1 RCM’s Entri Book solution provides greater transparency to patients while reducing administrative burdens through intelligent automation.

Key Features:

Automatic insurance validation and eligibility checks
Intelligent automation for quick responses
Enhanced patient experience tools

Pros & Cons:

Pros: Improves patient transparency; reduces administrative workload
Cons: May require integration with existing systems

Pricing:
Customized pricing; contact R1 RCM for more information.

Expert Commentary:
“R1 RCM’s solution has streamlined our prior authorization process, leading to faster patient care.” – Karen Smith, Revenue Cycle Director

15. Cohere Health

Cohere Health automates pre-authorization for medical treatments, aiming to improve care coordination and reduce unnecessary procedures.

Key Features:

AI-driven pre-authorization automation
Enhances care coordination
Reduces unnecessary medical procedures

Pros & Cons:

Pros: Improves care quality; reduces administrative tasks
Cons: Implementation may require workflow adjustments

Pricing:
Contact Cohere Health for pricing details.

Expert Commentary:
“Cohere Health’s platform has improved our care coordination and reduced redundant procedures.” – Dr. Emily Nguyen, Medical Director

Demo Video:
A Digital Authorization Platform to Transform Healthcare Utilization

16. Droidal

Droidal offers AI agents that automate insurance prior authorizations, aiming to cut costs and improve efficiency.

Key Features:

AI-driven prior authorization automation
Real-time status updates
Integration with existing systems

Pros & Cons:

Pros: Cost-effective; enhances efficiency
Cons: May require initial training for staff

Pricing:
Free trial available; contact Droidal for full pricing.

Expert Commentary:
“Droidal’s AI agents have significantly improved our prior authorization turnaround times.” – Lisa Thompson, Practice Manager

17. Banjo Health

Banjo Health focuses on prior authorization automation within the healthcare sector, utilizing artificial intelligence to streamline workflows.

Key Features:

AI-powered workflow automation
Real-time decision support
Integration with payer systems

Pros & Cons:

Pros: Enhances decision-making; reduces manual tasks
Cons: May require customization for specific practices

Pricing:
Contact Banjo Health for pricing information.

Expert Commentary:
“Banjo Health’s AI solutions have optimized our prior authorization processes, leading to better patient outcomes.” – Dr. Robert Allen, Chief Medical Officer

18. Silna Health

Silna Health provides an easy-to-use prior authorization software, recognized for its user-friendly interface and efficient processing.

Key Features:

Simplified prior authorization workflows
Real-time tracking and updates
Seamless integration with EHR systems

Pros & Cons:

Pros: Highly intuitive; quick implementation
Cons: May lack advanced features for complex cases

Pricing:
Contact Silna Health for pricing details.

Expert Commentary:
“Silna Health’s platform is incredibly user-friendly, making our prior authorization tasks much more manageable.” – Angela Davis, Office Administrator

19. ScriptSure

ScriptSure offers a comprehensive e-prescribing and prior authorization solution, integrating seamlessly with various healthcare systems.

Key Features:

E-prescribing with prior authorization capabilities
Real-time eligibility checks
Integration with multiple EHR platforms

Pros & Cons:

Pros: Combines prescribing and authorization; broad compatibility
Cons: May require training for optimal use

Pricing:
Contact ScriptSure for customized pricing.

Expert Commentary:
“ScriptSure’s integration of e-prescribing and prior authorization has streamlined our medication management process.” – Dr. Anthony Brown, Internist

20. Service Center

Service Center provides prior authorization software designed to enhance efficiency and reduce administrative burdens for healthcare providers.

Key Features:

Automated prior authorization workflows
Real-time status monitoring
Customizable templates and forms

Pros & Cons:

Pros: Reduces administrative workload; customizable
Cons: May require integration with existing systems

Pricing:
Contact Service Center for pricing information.

Expert Commentary:
“Service Center’s software has significantly reduced our prior authorization processing times.” – Michelle Lee, Practice Administrator

21. EHR 24/7®

EHR 24/7® offers electronic health record solutions with integrated prior authorization features to streamline clinical workflows.

Key Features:

Integrated prior authorization tools
Real-time eligibility verification
Comprehensive EHR functionalities

Pros & Cons:

Pros: All-in-one solution; enhances workflow efficiency
Cons: May be more suitable for larger practices

Pricing:
Contact EHR 24/7® for customized pricing plans.

Expert Commentary:
“EHR 24/7® has improved our clinical workflows by integrating prior authorization directly into patient records.” – Dr. Susan Miller, General Practitioner

Demo Video:
How to ePrescribe | AdvancedMD

22. RXNT

RXNT provides cloud-based healthcare software solutions, including prior authorization tools to enhance practice efficiency.

Key Features:

Cloud-based prior authorization management
Real-time status updates
Integration with billing and scheduling systems

Pros & Cons:

Pros: Cloud accessibility; comprehensive suite
Cons: May require internet connectivity for full functionality

Pricing:
Contact RXNT for pricing details.

Expert Commentary:
“RXNT’s cloud-based system has made managing prior authorizations more convenient and efficient.” – Dr. Kevin Harris, Pediatrician

23. Practice Fusion

Practice Fusion offers a cloud-based EHR platform with integrated prior authorization features to streamline patient care.

Key Features:

Integrated prior authorization tools
Real-time eligibility checks
User-friendly interface

Pros & Cons:

Pros: Easy to use; enhances patient care coordination
Cons: Limited customization options

Pricing:
Contact Practice Fusion for pricing information.

Expert Commentary:
“Practice Fusion’s integrated prior authorization features have improved our patient care coordination.” – Dr. Laura White, Family Medicine

24. Voluware

Voluware provides automation solutions to streamline prior authorization, helping healthcare providers reduce paperwork and speed approvals.

Key Features:

Automates prior authorization workflows
Real-time tracking and status updates
Integration with EHR and practice management systems

Pros & Cons:

Pros: Simplifies complex workflows; reduces administrative overhead
Cons: May require time for system integration

Pricing:
Custom pricing based on provider needs; contact Voluware directly.

Expert Commentary:
“Voluware’s automation has significantly reduced manual effort and improved turnaround times.” – David Richards, Healthcare IT Specialist

25. MedAssets

MedAssets offers a prior authorization platform designed to accelerate approvals and enhance revenue cycle management.

Key Features:

Streamlined prior authorization submissions
Analytics and reporting features
Integration with billing systems

Pros & Cons:

Pros: Enhances financial workflows; strong reporting tools
Cons: Pricing may be higher for smaller practices

Pricing:
Contact MedAssets for pricing details.

Expert Commentary:
“MedAssets helped us optimize prior authorizations and improve our revenue cycle.” – Jessica Powell, Revenue Cycle Manager

26. eviCore healthcare

eviCore healthcare provides prior authorization automation focused on evidence-based care and utilization management.

Key Features:

Evidence-based authorization processes
Fast eligibility and benefit verification
Integration with payer and provider systems

Pros & Cons:

Pros: Supports clinical decision-making; fast processing
Cons: Mainly targeted at larger healthcare organizations

Pricing:
Contact eviCore for pricing options.

Expert Commentary:
“eviCore’s evidence-based approach helps improve patient outcomes and approval efficiency.” – Dr. Jason Kim, Medical Director

27. Cerner Prior Authorization

Cerner offers a prior authorization solution embedded within its EHR platform to automate and speed up approvals.

Key Features:

Seamless EHR integration
Automated prior authorization submission and tracking
Real-time payer communication

Pros & Cons:

Pros: Fully integrated with Cerner EHR; reduces paperwork
Cons: Limited to Cerner users

Pricing:
Contact Cerner for detailed pricing.

Expert Commentary:
“Cerner’s integration simplifies prior authorizations for our clinical staff.” – Dr. Maria Gonzales, Health IT Coordinator

28. ZirMed (now part of Waystar)

ZirMed offers prior authorization automation as part of Waystar’s revenue cycle management platform.

Key Features:

Automated prior authorization requests and tracking
Real-time payer status updates
Comprehensive revenue cycle integration

Pros & Cons:

Pros: End-to-end revenue cycle solution; broad payer connectivity
Cons: May be complex for smaller practices

Pricing:
Contact Waystar for pricing information.

Expert Commentary:
“ZirMed’s prior authorization automation has improved our operational efficiency.” – Michael Turner, CFO

Demo Video:
Waystar Prior Authorization Demo

29. Availity Prior Authorization

Availity streamlines prior authorization through a centralized platform connecting providers and payers.

Key Features:

Real-time prior authorization submissions
Eligibility and benefit verification
Integration with major EHR systems

Pros & Cons:

Pros: Centralized platform; broad payer network
Cons: May have learning curve for new users

Pricing:
Contact Availity for pricing details.

Expert Commentary:
“Availity’s platform has unified our prior authorization workflows seamlessly.” – Karen Lee, Practice Manager

Demo Video:
Availity Prior Authorization Walkthrough

30. Epic Prior Authorization

Epic’s prior authorization solution is integrated within its EHR system, providing automated workflows to reduce delays.

Key Features:

Full EHR integration
Automated insurance verification and submissions
Real-time status tracking

Pros & Cons:

Pros: Deep integration within Epic ecosystem; improves clinical workflows
Cons: Only available to Epic users

Pricing:
Contact Epic for pricing.

Expert Commentary:
“Epic’s prior authorization tools have been instrumental in reducing delays in patient care.” – Dr. Amanda Roberts, Chief Medical Officer

Demo Video:
Epic Prior Authorization Overview

Conclusion

The way healthcare organizations handle treatment approvals and prescription delays is changing as a result of prior authorization automation systems. Staff friction is decreased, and patients receive care more quickly thanks to these tools, which replace manual labor with AI-powered, integrated systems. Take into account the volume of authorizations, the EHR compatibility of your company, and whether you require pharmacy, medical, or both kinds of PA support when selecting the best option. You may greatly reduce wait times, simplify compliance, and boost operational effectiveness with the correct platform.

Top 30 Best Prior Authorization Automation Solutions