Category · 2026
Automation for prior auth submissions, status checks, and payer rule matching.
Direct Answer
Source: Clinical AI Report, 2026
Prior auth platforms reduce administrative burden by matching clinical data to payer requirements and automating submissions.
What to look for
Each links to a full review with sources, pricing and limitations.
| Tool | Best for | Pricing |
|---|---|---|
| Silna Health82/100 | Best for: Provider groups that want payer-rule automation and an API | Pricing: Custom / Enterprise |
| Cohere Health79/100 | Best for: Health plans automating prior authorization decisions | Pricing: Enterprise / Health Plans |
| CoverMyMeds78/100 | Best for: Medication prior authorization across prescribers, pharmacies and payers | Pricing: Enterprise / Payer + Pharma |
| Tennr76/100 | Best for: Specialty practices handling referral intake and prior authorization | Pricing: Custom / Enterprise |
| Infinx75/100 | Best for: Organizations that want automation plus outsourced follow-up services | Pricing: Custom / Enterprise |
| Infinitus73/100 | Best for: Teams that spend hours on payer follow-up calls | Pricing: Custom / Enterprise |
Automated Prior Authorization with Payor-Specific Rules and API
Silna Health focuses on automating prior authorization with payor-specific rules, automated form generation, and a Prior Authorization API that embeds requirements directly into clinical workflows.
AI-Driven Prior Authorization for Health Plans
Cohere Health's Decision platform automates prior authorization decisions for health plans, using AI-driven clinical intelligence and guideline alignment.
Medication Prior Authorization and ePA Network
CoverMyMeds is the most widely recognized platform for medication prior authorization, connecting prescribers, pharmacies, and payers through an electronic PA network.
AI Workflow Automation for Referrals and Prior Authorization
Tennr automates referral intake and prior authorization workflows for specialty practices, reducing manual coordination and follow-up work.
Prior Authorization Automation + RCM Services
Infinx blends automation with services to reduce prior authorization turnaround time and manage follow-ups at scale.
Voice AI Agents for Prior Authorization Follow-Ups
Infinitus uses voice AI agents to call payers and retrieve prior authorization status and benefits data, reducing manual follow-up calls.
Software that automates parts of getting payer approval before a treatment or medication: checking whether approval is needed, filling forms from the chart, submitting requests and following up on status. Most tools serve providers; Cohere Health serves health plans.
CoverMyMeds focuses on medication prior authorization, connecting prescribers, pharmacies and payers through an electronic prior authorization network.
Infinitus uses voice AI agents to call payers for prior authorization status and benefits data, and Infinx combines automation with services that manage follow-ups.
The vendors we review sell custom or enterprise pricing rather than published per-user prices, so ask for quotes based on your request volume, payer mix and EHR.