10 Best Radiology & Imaging Prior Authorization Software

Quick answer: The best radiology prior authorization software in 2026 reflects a market shaped by radiology benefit managers (RBMs). eviCore, Carelon, RadMD/NIA, and HealthHelp are the payer-side gatekeepers a practice submits advanced imaging to; Honey Health, Infinx, Waystar, and Availity are the provider-side tools that automate getting through them; and Cohere brings AI to the payer's review. Honey Health leads the provider side for practices that want imaging PAs submitted and chased across payer and RBM portals inside their existing EHR. The right pick depends on whether you're trying to submit faster or you're the plan doing the reviewing.

Advanced imaging is one of the most prior-authorization-heavy services in medicine. An MRI, CT, or PET scan almost always needs approval, and that approval usually runs through a radiology benefit manager — a payer-side company that reviews imaging requests against evidence-based criteria. So "radiology prior authorization software" describes two very different things: the RBM platforms that decide, and the provider tools that submit. This guide ranks both, names a clear best-fit for each, and is honest about which side of the request each one serves.

Last updated: June 2026.

How we evaluated radiology PA software

We looked at the software involved in getting imaging approved — RBM platforms, clearinghouse connectivity, and provider-side automation. The dimensions that separated the field:

• Which side it serves — the payer/RBM reviewing, or the provider submitting?
• What it does — render determinations, route the request, or work it end to end?
• Imaging depth — advanced imaging (MRI/CT/PET) criteria and RBM coverage.
• EHR and portal fit — does it operate across the RBM and payer portals you use?
• Automation level — manual portal work, rules-based, or AI that submits and chases.

This isn't a single-winner ranking. A health plan running imaging UM and an imaging center trying to clear authorizations faster need opposite tools, so each entry carries a clear "best for." Imaging PA is heavy enough that practices keep dedicated staff on it — part of the roughly 13 hours a week the AMA's 2025 survey attributes to PA. This is a spoke of our prior authorization software hub; for the AI-native subset, see the AI radiology PA tools companion.

Radiology PA software at a glance

The 10 best radiology and imaging PA software platforms in 2026

1. Honey Health — best for end-to-end imaging PA across payers and RBMs

Honey Health is built for the part of imaging PA that hurts: getting through the RBM. Its AI agent identifies the imaging PA requirement in the EMR, logs into the right portal — a payer's, or an RBM portal like eviCore, Carelon, or RadMD — submits the request with the clinical justification, monitors status, and writes the decision back to the chart. Because it uses agentic browser automation, it navigates those RBM and payer portals the way a staff member would, across 20+ EHRs, with no integration project.

Pricing is per completed PA, roughly $1.50–$2 including status follow-up. Honey reports about one FTE offset per 25 new PAs a day, 80–95% less manual effort, and 99.8–99.9% accuracy, with most practices live in two to three weeks and no onboarding fee.

The honest limit: Honey is provider-side, so it helps you get approvals — it isn't the RBM rendering them, and it's newer than the incumbents below. For imaging centers and practices drowning in MRI/CT/PET authorizations across multiple RBMs and payers, an agent that works each portal end to end is the best fit.

2. eviCore by Evernorth — best-known imaging RBM

eviCore, part of Evernorth (Cigna), is the dominant radiology benefit manager — many major health plans route advanced-imaging authorizations through it, and providers submit clinical reviews and check status in its provider portal against evidence-based criteria. If your payer uses eviCore, it's effectively the gatekeeper for your imaging approvals.

The framing matters: eviCore is a payer-side UM company, not software a practice buys. You experience it as the reviewer your requests must satisfy, which is exactly why provider-side tools focus on getting through it efficiently. Best to understand as the imaging RBM many of your payers rely on.

3. Carelon Medical Benefits Management — best for a major imaging RBM

Carelon Medical Benefits Management (part of Elevance Health, formerly AIM Specialty Health) is another of the large radiology benefit managers, applying evidence-based criteria to advanced-imaging requests for the plans that contract it. For practices whose payers use Carelon, its portal and rules define the imaging-approval path.

Like eviCore, Carelon is payer-side — the entity you submit to, not a tool you license — so a practice's job is to clear its criteria quickly. Best to understand as the imaging RBM behind a large share of commercial plans.

4. RadMD / NIA (Evolent) — best for an imaging RBM submission portal

RadMD is the real-time provider portal for National Imaging Associates (NIA), now part of Evolent, giving ordering and rendering providers access to imaging prior authorization requests and status for the plans that use NIA. It's where a lot of radiology authorizations actually get submitted and tracked.

RadMD is the submission portal for a specific RBM, so its usefulness depends on which of your payers route through NIA/Evolent, and the work of filling and chasing requests in it still falls to staff. Best for providers submitting imaging PAs to plans that use NIA/Evolent.

5. HealthHelp — best for consultative imaging benefit management

HealthHelp (a WNS company) takes a different approach to imaging UM: a consultative, educational model that uses peer-to-peer expert consultation rather than a denial-driven process, partnering with health plans to manage advanced imaging and other specialty benefits. For the plans that use it, the experience is more collaborative than a hard gate.

HealthHelp is still a payer-side benefit manager, so it's the reviewer rather than provider software, and its consultative model means engaging with its clinical guidance. Best to understand as the imaging benefit manager for plans that favor a consultative UM model.

6. Infinx — best for provider-side imaging PA automation

Infinx is a provider-side platform with deep radiology focus: its AI-driven software submits imaging prior authorizations to eviCore, Carelon, and various payers from one place, applies an AI determination engine, and integrates bidirectionally with the EHR, with radiology coding support alongside. It targets imaging centers and radiology groups specifically.

Infinx blends software with services, so the model is more of a managed partnership than a self-serve tool, and the experience varies with how much you lean on its team. Best for radiology and imaging centers that want AI-assisted PA submission plus coding support across RBMs.

7. Cohere Health — best for AI imaging utilization management

Cohere Health brings AI to the payer side of imaging and musculoskeletal authorization, helping plans run utilization management and auto-approve requests that clearly meet criteria. It raised a $90 million Series C in 2025 and is among the AI-forward names modernizing imaging UM.

For a practice, Cohere is payer-side — when your plan runs it, approvals can move faster, but it isn't a tool you buy to submit. Best for health plans modernizing imaging and MSK utilization management, and useful for practices to recognize as the AI increasingly reviewing their requests.

8. Availity — best for payer connectivity for imaging PA

Availity operates one of the largest health-information networks, giving providers a single connection to many payers for eligibility, claims, and prior authorization — including imaging — so requests and status can flow through one portal rather than many. For practices that live in payer portals, it consolidates the connection.

Availity is connectivity, not a dedicated imaging-PA engine: it routes to payers that participate, and the clinical work of the request still falls to staff, with RBM-specific steps sometimes outside its reach. Best for practices that want a single payer-connectivity hub that includes imaging PA.

9. Waystar — best for PA automation inside an RCM suite

Waystar is a major revenue-cycle platform whose authorization module automates parts of prior authorization, including imaging — checking requirements, initiating requests, and tracking status within a broader RCM workflow. For organizations already running Waystar for billing, adding its PA automation keeps it in one system.

PA is one module in a large RCM suite, so its imaging-specific depth and RBM coverage are narrower than a dedicated tool, and it's most compelling if you're already a Waystar shop. Best for groups that want imaging PA automation inside the RCM platform they already use.

10. Myndshft (DrFirst) — best for knowing if imaging needs a PA

Myndshft, now part of DrFirst, provides real-time determination of whether a service — including advanced imaging — requires prior authorization for a given plan, plus the requirements and eligibility data behind it. It answers the upfront question so staff don't submit unnecessary requests or miss required ones.

Myndshft handles the determination and eligibility step rather than working the request through the RBM to approval, so it pairs with a submission tool. Best for organizations that want to know upfront whether an imaging study needs a PA and what it requires.

How do you choose radiology PA software?

First, recognize the RBM reality. For most advanced imaging, the decision runs through eviCore, Carelon, NIA/Evolent, or HealthHelp — payer-side gatekeepers you submit to, not tools you buy. Knowing which RBM each of your payers uses tells you which portals your staff have to work.

Then decide how you want to get through them. A determination tool like Myndshft tells you when a PA is needed; connectivity hubs like Availity and RCM suites like Waystar consolidate submission; and an AI agent that logs into each RBM and payer portal, submits, and chases — the way Honey Health's does — replaces the manual portal grind that imaging PA is notorious for. Infinx pairs automation with hands-on services for imaging centers specifically.

Finally, separate your seat from the other side's. If you're a plan, the AI UM tools (Cohere, and the RBMs' own automation) are yours; if you're a provider, your shortlist is the tools that get you approved faster. For the AI-native shortlist on the provider and payer sides, see our AI radiology PA tools guide.

Frequently asked questions

What is radiology prior authorization software?

Radiology prior authorization software is the technology involved in approving advanced imaging. It includes the radiology benefit manager (RBM) platforms that payers use to review imaging requests against criteria, and the provider-side tools that help practices submit those requests and track them to a decision.

What is a radiology benefit manager (RBM)?

An RBM is a company a health plan contracts to manage imaging utilization — reviewing MRI, CT, PET, and similar requests against evidence-based criteria and approving or denying them. eviCore, Carelon, NIA/Evolent, and HealthHelp are the major RBMs. Providers submit imaging authorizations through the RBM their patient's plan uses.

Why does advanced imaging almost always need prior authorization?

Advanced imaging is high-cost and sometimes over-ordered, so payers route it through RBMs to confirm it meets evidence-based criteria before approving. That makes imaging one of the most PA-heavy services in a practice — and the reason dedicated software and automation exist to get requests through the RBM efficiently.

Can software automate imaging prior authorization for a practice?

Yes. Provider-side tools automate submission and tracking, and AI agents go further — logging into the RBM and payer portals, submitting the request with clinical justification, and chasing status. Honey Health's agent does this end to end across portals, reporting 80–95% less manual effort and 99.8–99.9% accuracy, with edge cases routed to staff.

How is RBM software different from provider PA tools?

RBM software (eviCore, Carelon, NIA, HealthHelp) is payer-side — it renders the imaging decision. Provider PA tools (Honey Health, Infinx, Waystar, Availity) are practice-side — they help you submit to the RBM and get approved. A practice can't buy an RBM platform to fix its queue; it needs the provider-side tools that work through them.

Radiology PA is defined by the RBM in the middle. Learn which RBMs your payers use, then choose the provider-side tooling that gets you through them fastest — and for an agent that logs into each RBM and payer portal to submit and chase imaging authorizations end to end, inside your existing EHR, Honey Health is the place to start.