Best Prior Authorization Software - Page 2
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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Cohere helps health plans digitize the process and apply clinical intelligence to enable in-house, end-to-end automation of prior authorization. Health plans can directly license Cohere’s PaaS intelli
317 Twitter followers
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DART Chart provides payment integrity and managed care compliance solutions focused on the long term care industry. It provides service to long term care post acute providers, state government agencie
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**eBlu Solutions** offers a software platform that simplifies and accelerates the patient access process for high-cost infusion and injection therapies. Designed for specialty healthcare practices, it
- Overview
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1st Providers Choice's Electronic Prior Authorization (ePA software streamlines the traditionally cumbersome prior authorization process, enabling healthcare providers to obtain approvals for prescrip
281 Twitter followers
- Overview
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Empowered by Innovation Exchange EDI offers a cloud based solution in the revenue cycle management space with products like Prior Authorizations, Patient Estimation and Healthcare Payments.
- Overview
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From coding and billing support to claims management systems, medical lockbox solutions, and integrated data management, Exela offers full claim lifecycle tools that improve patient financial services
- Overview
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Experian Health's Prior Authorization software is an integrated online service designed to automate and streamline the prior authorization process for healthcare providers. By reducing manual paperwor
38,512 Twitter followers
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Flow's AI agents automate everything from detection to appeals using the medical necessity guidelines, so your team focuses on exceptions, and submissions meet requirements the first time.
3,319 Twitter followers
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Glidian is a comprehensive prior authorization platform designed to streamline the authorization process between healthcare providers and payors. By integrating directly with a vast network of insuran
- Overview
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Honey Health is the AI back office for healthcare. We help primary and specialty care organizations automate manual administrative work with a team of AI agents. This includes tasks like data collecti
- Overview
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Infinx Healthcare provides innovative and scalable prior authorization and revenue cycle management solutions for healthcare providers, hospitals, imaging centers, and laboratories. Combining intellig
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Clinical Decision Support (CDS) system is a next-generation decision-support solution available to providers today.
- Hospital & Health Care
- 50% Small-Business
- 40% Enterprise
880 Twitter followers
- Overview
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Automated EHR and Medical Billing Solutions MediFusion is a fully integrated cloud-based software designed to offer the latest EHR and medical billing solutions to healthcare practices and improve cli
- Overview
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Olive is the automation company creating the Internet of Healthcare. Addressing healthcare's most burdensome issues with intelligent automation, Olive shines a bright light that drives connections bet
- Overview
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PAHub is a web-based solution designed to automate the end-to-end management of Electronic Prior Authorization (ePA) across all healthcare services, all lines of business, and all channels.
