In today’s fast-evolving healthcare landscape, the demand for quicker and more accurate medical approvals is more pressing than ever. Prior authorization—a process used by insurance companies to determine if they will cover a prescribed procedure, service, or medication—can be notoriously slow and frustrating for both patients and healthcare providers. Enter the age of innovation, where technology is transforming how these approvals are handled. In 2025, a number of standout companies are leading the way in streamlining these once-cumbersome workflows. This article explores the top prior authorization companies revolutionizing the healthcare approval process this year.
List of Prior Authorization Companies
1. ScribeRunner
Headquarters: United States
Founded: 2020
Specialization: AI-powered prior authorization automation
ScribeRunner leads the pack in 2025 with its state-of-the-art AI platform specifically designed to automate and accelerate the prior authorization process. ScribeRunner’s platform integrates seamlessly with Electronic Health Records (EHRs) and uses machine learning to auto-generate and submit prior auth requests. It offers real-time status tracking, analytics, and a significant reduction in manual work, enabling physicians to spend more time with patients rather than paperwork. Its user-friendly dashboard and robust payer integration make it a favorite among both large hospital networks and small clinics.
2. CoverMyMeds
Headquarters: Columbus, Ohio
Founded: 2008
Specialization: Medication prior authorization
CoverMyMeds has long been a trusted name in the prior authorization world. In 2025, its platform continues to support both pharmacy and medical benefit coverage, offering transparency and seamless integration with prescribers and pharmacists. With a focus on helping patients access medications faster, the platform automates manual processes and ensures fewer delays, denials, and disruptions in treatment.
3. Availity
Headquarters: Jacksonville, Florida
Founded: 2001
Specialization: Real-time health information exchange
Availity’s prior authorization solutions are part of its broader mission to connect payers and providers via a secure digital platform. The company’s advanced analytics and predictive modeling help reduce the administrative burden, improving care coordination across different entities. It supports both batch and real-time transactions, making it a reliable option for large health systems.
4. Parachute Health
Headquarters: New York, New York
Founded: 2016
Specialization: Medical equipment and supply ordering
Parachute Health provides a unique value proposition by focusing on the ordering of durable medical equipment (DME) and supplies, which often require prior authorization. Their cloud-based platform reduces the complexity of DME orders, eliminates faxed paperwork, and delivers prior auth requests directly to insurance companies. With a growing user base, Parachute Health continues to improve patient outcomes and provider satisfaction.
5. Verata Health (Acquired by Olive AI)
Headquarters: Columbus, Ohio
Acquired: 2021
Specialization: AI for medical authorization
Now a part of Olive AI, Verata Health provides an AI-driven approach to prior authorizations. The platform proactively determines whether prior auth is required and generates clinical documentation to meet payer criteria. This enables faster turnaround times and fewer delays in patient care. Their smart automation also helps reduce denial rates, which is a major pain point in the healthcare ecosystem.
6. Cohere Health
Headquarters: Boston, Massachusetts
Founded: 2019
Specialization: Value-based prior authorization
Cohere Health differentiates itself by aligning prior authorizations with value-based care. Their platform supports evidence-based treatment pathways, allowing providers to make clinical decisions that are more likely to be approved. This results in fewer denials and delays. With a focus on musculoskeletal and cardiology services, Cohere Health is making great strides in specialty care.
7. HealthHelp (A WNS Company)
Headquarters: Houston, Texas
Founded: 1999
Specialization: Specialty benefits management
HealthHelp offers evidence-based prior authorization services with a strong emphasis on medical imaging, cardiology, and oncology. The company focuses on collaborative decision-making between payers and providers to reduce unnecessary services while improving outcomes. With decades of experience, HealthHelp remains a significant player in the space.
8. Rhyme (formerly known as Myndshft)
Headquarters: Mesa, Arizona
Founded: 2013
Specialization: Automation for prior authorizations and benefits verification
Rhyme automates the end-to-end process of medical benefit checks and prior authorizations using a cloud-native platform. Their solution includes payer policy validation, clinical review automation, and electronic submission workflows. The use of AI-driven eligibility rules has earned them praise for improving speed and accuracy.
9. ZappRx (Now part of Allscripts)
Headquarters: Boston, Massachusetts
Acquired: 2019
Specialization: Specialty medication management
ZappRx, now integrated into Allscripts, specializes in streamlining prior authorization for specialty medications. By simplifying enrollment and authorization for therapies that are often complex and expensive, the platform minimizes patient wait times and improves adherence. Providers can initiate, track, and complete approvals all within a single digital interface.
10. Surescripts
Headquarters: Arlington, Virginia
Founded: 2001
Specialization: E-prescribing and prior authorization
Surescripts offers electronic prior authorization integrated with its e-prescribing platform. Physicians can see prior auth requirements at the point of care, reducing the back-and-forth with insurance providers. The system is known for its nationwide reach and strong partnerships with pharmacies, prescribers, and payers.
11. Navina
Headquarters: New York, NY
Founded: 2018
Specialization: AI-powered clinical intelligence and prior auth insights
Navina uses artificial intelligence to organize patient data and highlight medical necessity, expediting the prior authorization process. It integrates with EHRs to surface authorization needs in real time, helping physicians justify treatments faster and with more accuracy.
12. PriorAuthNow
Headquarters: Columbus, Ohio
Founded: 2014
Specialization: Real-time medical prior authorization
PriorAuthNow offers an enterprise-grade platform that automates the prior authorization process from start to finish. It connects with health plans and EHRs to reduce phone calls and faxes, making it a favorite for large health systems and outpatient providers.
13. Edifecs
Headquarters: Bellevue, Washington
Founded: 1996
Specialization: Payer-provider interoperability for prior auth
Edifecs focuses on aligning payer and provider data to support value-based care initiatives. Their Authorization Hub uses FHIR and other modern APIs to digitize and automate authorizations, improving speed and compliance.
14. Change Healthcare (Optum Insight)
Headquarters: Nashville, Tennessee
Founded: 2007 (acquired by Optum in 2022)
Specialization: Nationwide prior auth network solutions
A longstanding leader in healthcare tech, Change Healthcare offers a robust suite of automated prior authorization tools. With deep payer connectivity, their platform speeds up approvals for a wide range of medical services and procedures.
15. Moxe Health
Headquarters: Madison, Wisconsin
Founded: 2012
Specialization: Data exchange and prior authorization APIs
Moxe enables prior authorization through automated data sharing between providers and payers. It supports electronic medical record extraction and decision support to help justify authorizations more quickly and efficiently.
16. Experity Health
Headquarters: Machesney Park, Illinois
Founded: 2019 (via merger of DocuTAP and Practice Velocity)
Specialization: Urgent care solutions including prior auth tools
Experity serves urgent care centers with a complete platform that includes real-time prior authorization capabilities. It’s especially useful in time-sensitive care environments where delays can impact patient throughput.
17. AuthPal
Headquarters: San Francisco, California
Founded: 2021
Specialization: Cloud-based prior authorization platform for providers
A rising startup, AuthPal offers a clean, intuitive platform focused on simplifying authorization for independent practices. It uses AI-driven templates and payer-specific workflows to minimize manual entry and reduce denials.
18. Infinx Healthcare
Headquarters: San Jose, California
Founded: 2012
Specialization: End-to-end revenue cycle and prior authorization services
Infinx combines automation with a dedicated team of specialists to manage prior auths for radiology, orthopedics, cardiology, and more. Their real-time dashboards and payer rules engine boost transparency and turnaround.
19. MedPrior
Headquarters: Dallas, Texas
Founded: 2018
Specialization: Prior authorization services for small clinics
MedPrior focuses on serving small-to-mid-sized healthcare providers with cost-effective prior auth services. They offer a hybrid of automation and human review, helping clinics handle approvals without extra staff.
20. XIFIN
Headquarters: San Diego, California
Founded: 1997
Specialization: Lab and diagnostics revenue cycle management
XIFIN’s platform includes prior authorization automation tailored to diagnostics and lab testing. By integrating lab ordering with payer authorization rules, it ensures testing is reimbursable before it’s even conducted.
21. Kepro
Headquarters: Nashville, Tennessee
Founded: 1985
Specialization: Utilization management and federal prior authorization contracts
Kepro is a longstanding partner to government healthcare programs like Medicare and Medicaid, providing evidence-based prior authorization reviews. Its solutions ensure compliance, reduce unnecessary services, and improve care quality through clinical expertise and tech-enabled workflows.
22. Raintree Systems
Headquarters: Temecula, California
Founded: 1983
Specialization: Rehab and therapy practice management with prior auth tools
Raintree’s end-to-end healthcare platform includes built-in prior authorization tracking for outpatient therapy clinics. It automates insurance eligibility checks, authorization alerts, and progress note validation—streamlining workflows for physical, occupational, and speech therapy.
23. Zelis
Headquarters: Bedminster, New Jersey
Founded: 2004
Specialization: Payer-focused claims and prior authorization management
Zelis works closely with payers to reduce friction in the authorization and claims process. Its platform integrates prior authorization checks with payment accuracy solutions, helping both payers and providers minimize costs and improve member satisfaction.
24. SmartCareDoc
Headquarters: Chicago, Illinois
Founded: 2016
Specialization: Telehealth platforms with built-in prior authorization workflows
SmartCareDoc offers telehealth platforms for remote patient management that include prior authorization capabilities. It ensures that virtual consultations requiring prescriptions or imaging get approved in real time, allowing seamless continuation of care.
25. ImagineSoftware
Headquarters: Charlotte, North Carolina
Founded: 2000
Specialization: Revenue cycle and prior authorization automation for radiology
ImagineSoftware specializes in revenue cycle automation for imaging and radiology centers. Their platform includes automated prior auth tools, payer rule intelligence, and status tracking, helping radiologists avoid delays and improve billing accuracy.
Why Prior Authorization Companies Matter in 2025
The healthcare system is undergoing a digital renaissance, and prior authorization processes are no exception. Manual methods are not only slow but prone to errors and delays that can negatively impact patient outcomes. By adopting platforms offered by leading prior authorization companies, healthcare providers can automate, streamline, and secure approval processes with minimal administrative effort.
These companies are playing a vital role in enhancing the patient experience and reducing burnout among healthcare professionals. By integrating with existing clinical workflows and providing real-time updates, they ensure that doctors, pharmacists, and insurance providers are all on the same page.
Future Trends in Prior Authorization
Looking ahead, we can expect more AI-powered decision support tools, increased payer-provider interoperability, and widespread use of real-time data analytics. Blockchain may also enter the space to improve security and transparency. Moreover, with federal pressure to improve prior auth turnaround times, these companies will continue to innovate aggressively.
FAQs
1. What is a prior authorization company?
A prior authorization company provides software or services that help streamline the approval process required by insurers before certain medications, procedures, or treatments are covered.
2. Why are prior authorizations needed?
They are used by insurance companies to ensure that a treatment or medication is medically necessary and cost-effective before it is approved for payment.
3. How do these companies help providers?
They reduce administrative workload, speed up approval times, and integrate prior auth workflows into existing EHR systems.
4. Is prior authorization automation secure?
Yes, reputable companies follow strict data security and HIPAA compliance protocols to ensure patient information remains confidential.
5. Can patients benefit from prior authorization platforms?
Indirectly, yes. Faster approvals mean quicker access to medications and treatments, leading to better health outcomes.