10 Best Prior Authorization Software (2026)

Quick answer: The best prior authorization software in 2026 automates the full PA workflow — finding the requirement, submitting it to the payer, and chasing the status — instead of just storing forms or routing faxes. For practices that want PA handled end to end inside their existing EHR, Honey Health leads this list with AI agents that work across 20+ EHRs and payer portals with no integration. Cohere Health and CoverMyMeds are strong for payer-aligned and medication PA, while Availity, Waystar, and Surescripts fit teams that want authorization inside a broader network or RCM suite. The right pick depends on your PA mix, your EHR, and how much you want automated versus staffed.

Prior authorization is one of the heaviest administrative loads in a practice. In the AMA's 2024 prior authorization survey, physicians reported completing about 39 PAs a week and spending roughly 13 hours on them, with 93% saying PA delays patient care and 29% reporting that it had led to a serious adverse event for a patient. The software below tackles that load in very different ways — from medication ePA networks to clearinghouses to AI agents that work the queue for you. Here are the ten worth knowing in 2026, how they differ, and who each one fits.

Last updated: June 2026.

How we evaluated these tools

We looked at software that actually moves prior authorizations forward, not just stores them. The dimensions that separated the field:

• Automation depth — does it route and assist, or submit and follow up on its own?
• PA types covered — medication only, or medical, imaging, procedure, and specialty drug too?
• EHR and payer fit — does it work where your team already works, or require an integration project?
• Model — software, network, clearinghouse, services hybrid, or agentic AI?
• Pricing and segment — what it costs and who it's built for.

This isn't a single-winner ranking. Prior authorization software is bought for a specific PA mix and a specific EHR, so each tool below carries a clear "best for." The 2024 CAQH Index estimates the industry could save roughly $21 billion a year by moving the remaining manual prior authorizations to fully electronic, and that providers save about 14 minutes per request when they do — so we favored tools that cut manual touches, not just digitize them. To be included, a tool had to offer software-driven PA automation, serve US practices in 2026, work with real payer and EHR systems, and be HIPAA-compliant.

Prior authorization software at a glance

The 10 best prior authorization software platforms in 2026

1. Honey Health — best for end-to-end PA inside your existing EHR

Honey Health runs prior authorization as an AI "staff" member rather than a form-routing tool. Its agents log into your EHR and payer portals the way a person would, identify the PA requirement, submit it, monitor the status across the days a payer can take to respond, and write the decision back into the chart for the next step. Because it uses agentic browser automation — not an API integration or a brittle RPA script — it works inside the systems you already run, across 20+ EHRs including Epic, Oracle Health (Cerner), athenahealth, eClinicalWorks, and NextGen, plus payer portals like Availity. There's no integration project and no separate app your staff has to learn.

Coverage spans medication, imaging/diagnostic, specialty-drug (biologics and infusions), and procedure PA. Pricing is per task — roughly $1.50–$2 per completed PA including the status follow-up — so cost tracks volume instead of headcount. Honey reports customers offsetting about one full-time employee for every ~25 new PAs a day, 80–95% less manual effort on the workflow, and task accuracy in the 99.8–99.9% range, with most practices live in two to three weeks and no onboarding fee.

The trade-off: Honey is AI-native and built for the practice side of PA, so it isn't a payer-side utilization-management system, and it doesn't currently target office-visit PA. Groups that want one vendor to automate medication, imaging, procedure, and specialty-drug PA end to end — without ripping out their EHR — are the best fit.

2. Cohere Health — best for payer-aligned utilization management

Cohere Health approaches prior authorization from the health-plan side. Its platform uses clinical intelligence to run utilization management and auto-approve requests that clearly meet criteria, which can cut turnaround on the authorizations a plan touches. Practices most often encounter Cohere through the payers that contract with it, where it speeds determinations and reduces back-and-forth on medical and procedural PA. Pricing reflects that model — typically per-member-per-month or per-authorization arrangements scaled to plan membership rather than a published per-seat price.

That payer alignment is both the strength and the catch. When your payer runs Cohere, approvals can move faster — but Cohere isn't a tool a practice buys to work its own PA queue across every payer. It's oriented to plans and risk-bearing entities. Groups that want a practice-side workflow to submit and track PAs across all of their payers will find it a partial fit. Best for organizations whose PA pain concentrates with Cohere-aligned plans, or risk-bearing groups managing utilization internally.

3. CoverMyMeds — best for high-volume medication PA

CoverMyMeds, part of McKesson, runs the most widely used electronic prior authorization network for medications. It connects prescribers, pharmacies, and payers so a drug PA can start at the point of prescribing and route electronically instead of by fax, and it's generally free to providers because payers and pharma fund it. Its 2025 push into specialty medications — through integrations like RxLightning and FastAuth — reported completing 72% of specialty enrollments in under a day, most in under an hour, with APIs that feed status back into EHR and pharmacy systems.

The limitation is scope. CoverMyMeds is built around medication PA; it doesn't handle the medical, imaging, or procedure authorizations that drive denials in surgical and specialty practices. It also routes and facilitates rather than working the request autonomously on your behalf — someone on your team still owns the medical-PA queue. Best for practices that want a proven, low-cost backbone for medication ePA and handle medical PA elsewhere.

4. Surescripts — best for ePA inside e-prescribing

Surescripts operates the national e-prescribing network most practices already touch, and its electronic prior authorization sits inside that prescribing flow. Its automation pulls clinical data from the EHR, sends it to the pharmacy benefit manager, and can return a decision in as little as 18 seconds for supported medications. By late 2025 the company reported the capability spanning more than 70 medications and over 76,000 prescribers, which removes a separate step for a large share of medication authorizations.

Like CoverMyMeds, Surescripts is medication-centric and infrastructural — a network that enables ePA, not a workflow product that manages your authorizations end to end or covers medical and procedural PA. Its value shows up quietly through your EHR and e-prescribing vendor rather than as a tool your team logs into. Best for practices that want fast medication ePA embedded in prescribing and already rely on Surescripts-connected systems.

5. Rhyme — best for payer–provider PA connectivity

Rhyme (formerly PriorAuthNow) connects providers and payers through its LiveAuth network so authorizations can be submitted and returned on one platform rather than payer-by-payer portals. It integrates with major EHRs including Epic, Cerner, and athenahealth, supports gold-carding programs that can remove PA at the point of care, and reports a network of 300+ payers and 91 large health systems processing more than 4 million authorization cases a year. It's also exploring touchless PA at the point of care through a collaboration with Microsoft's Dragon Copilot.

The dependency cuts both ways: Rhyme works best where the payer participates, and coverage varies by plan. It's a connectivity layer more than a hands-on agent that works your queue, so practices still need staff or another tool for the requests Rhyme doesn't fully close. Best for groups that want to consolidate PA submission across participating payers into a single connection.

6. Availity — best for clearinghouse-based auth and eligibility

Availity is one of the largest health information networks in the country, and many practices already use it for eligibility and claims. Its authorization tools let staff submit and check medical authorizations (the 278 transaction) across a wide set of payers from one place, with routing, status tracking, and real-time responses — and the company is aligning its APIs to the CMS-0057-F interoperability rule that mandates FHIR-based PA workflows.

Availity's breadth is real, but depth varies by payer — some connections are rich, others thin — and the data returned is only as current as the payer feeds behind it. It's a place for your team to do PA, not a system that does PA for them. Best for practices that want a multi-payer hub for authorization and eligibility and have staff to work it.

7. Waystar — best for PA inside an RCM suite

Waystar is a revenue cycle platform, and in 2025 it expanded PA through its Auth Accelerate product, which automates each step of the authorization process. Waystar reports it cuts submission time by about 70%, reaches roughly 85% auto-approval, and reduces average payer wait from more than four days to a day or less. For groups already on Waystar — or shopping for a full RCM suite — having PA in the same system as claims ties authorizations to downstream billing.

The trade-off is commitment and focus. PA is one module in a large suite, so it's strongest for organizations buying the whole platform rather than a dedicated PA solution. Best for mid-to-large groups standardizing revenue cycle on Waystar that want authorization handled next to claims.

8. Infinx — best for a software-plus-services hybrid

Infinx pairs PA software with onshore and offshore staff who work the authorizations its automation doesn't finish, covering both medication and medical PA. Pricing is custom and usage- or contingency-based — a percentage of recoveries, or a subscription plus per-document fees — rather than a published rate, and the offering is reviewed in industry sources like KLAS.

That services layer is the difference from pure software. It can mean lower internal labor but a cost structure closer to outsourcing, and less direct control than a tool your own team drives — throughput depends partly on Infinx's staff, not only on automation. Best for groups that would rather outsource PA as a managed service than operate software themselves.

9. Myndshft — best for real-time benefit and PA determination

Myndshft focuses on the data side of authorization: real-time benefit verification, PA-requirement determination, and the rules that decide whether a service even needs a PA. It reports running real-time benefit checks for more than 93% of covered lives, an automated precheck that predicts an outcome before submission, and logic that identifies whether a given CPT/HCPCS code needs PA across payers and the right way to submit it — with up to 90% less time and effort on benefit checks and authorizations.

Because it concentrates on determination and benefit data, Myndshft is often a layer within a broader workflow rather than the system that submits and follows every request to closure. Best for organizations that want accurate, real-time PA-requirement and benefit data feeding their existing process.

10. Silna Health — best for AI-native specialty and infusion PA

Silna Health is an AI-native entrant focused on end-to-end prior authorization, benefit checks, and eligibility for specialty care, where a single PA can carry heavy clinical documentation. In 2025 it raised about $27 million, including a $22 million Series A co-led by Accel and Bain Capital Ventures, and reports working across payer portals to cut approval times from weeks to hours, having supported more than 50,000 patients — with strength in areas like ABA and rehabilitation.

As a younger, specialty-focused company, its footprint is narrower than the incumbents above, and practices outside specialty and infusion may find the fit less direct. Best for infusion centers and specialty groups that want AI-native PA tuned to their authorization mix. For a full shortlist of AI-native options across all PA types, see our companion guide to the best AI prior authorization tools.

How do you choose the right prior authorization software?

Start with your PA mix. If most of your authorizations are for medications, a medication ePA backbone like CoverMyMeds or Surescripts may cover the bulk of the work. If your denials come from imaging, procedures, or specialty drugs, you need a tool that handles medical and procedural PA — not just pharmacy.

Then weigh how much you want automated versus staffed. Networks and clearinghouses (Availity, Rhyme, Surescripts) give your team a better place to do PA; a services hybrid (Infinx) does it for you with people; agentic AI (Honey Health, Silna Health) aims to work the request end to end with software.

Finally, factor in your EHR and the cost of integration. Tools that require an interface project or a new system for staff to learn carry a hidden tax. Approaches that operate inside your existing EHR and payer portals — the way Honey Health's agents do — avoid it. If your volume is concentrated in one area, we cover medication, radiology and imaging, procedure and surgical, specialty-drug, and office-visit PA in dedicated guides.

Frequently asked questions

What is prior authorization software?

Prior authorization software helps practices obtain payer approval for medications, procedures, and services before they're delivered. The strongest tools automate the full workflow — identifying when a PA is required, submitting it to the payer, tracking status, and recording the outcome — rather than only storing forms or routing faxes.

Can AI fully automate prior authorization?

AI can now handle most of the PA workflow on its own, especially submission and status follow-up. Agentic tools like Honey Health work requests end to end across payer portals and write results back to the EHR, with people stepping in only on genuine edge cases. How hands-off it gets depends on your payer mix and the complexity of each authorization.

How much does prior authorization software cost?

Pricing models vary widely. Medication ePA networks like CoverMyMeds and Surescripts are often free to providers because payers fund them; clearinghouses and RCM suites bundle PA into broader fees; services hybrids price on contingency or usage; AI agents like Honey Health charge per completed task (roughly $1.50–$2 per PA), which ties cost directly to volume instead of headcount.

Does prior authorization software work with my EHR?

It depends on the approach. API-based tools require an integration per EHR. Agentic browser automation, like Honey Health's, works inside the EHR and payer portals your staff already use — across 20+ EHRs — without an integration project, which is why it can go live in two to three weeks.

What's the difference between general PA software and AI PA tools?

General PA software spans networks, clearinghouses, RCM modules, and AI tools — the full field of ways to manage authorizations. AI PA tools are the AI-native subset that automate the work itself. If you want only the AI-native options, see our companion guide to the best AI prior authorization tools.

Prior authorization isn't one problem, so the best software isn't one tool. Medication-heavy practices, surgical groups, and infusion centers each have a different PA mix and a different best fit. If your goal is to take the whole workflow off your staff's plate — across medication, imaging, procedure, and specialty-drug PA, inside the EHR you already run — an agentic option like Honey Health is the place to start.