Scaling AI technology to automate prior authorization across all specialties and payers
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AI-driven clinical review to instantly compare prior authorization submissions to clinical guidelines
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As a "recovering radiologist" from Mayo Clinic and Harvard I experienced first hand the struggles of prior authorization. After learning that payers also despise the cumbersome, costly process, I set out on a mission to bring providers and payers together to automate and solve the problem so patients can get the care they deserve and reduce costs and waste that plague our healthcare system.
Six years ago, we started building an artificial intelligence solution to solve PA for all "ologies". After a couple acquisitions and tens of millions of dollars invested in the technology, I'm thrilled to be back on this mission with an amazing team here at Humata Health. While we've helped millions of patients, the time is now to deliver truly "frictionless prior authorization" at scale so every patient gets the care they deserve and the process is touchless.
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As a physician-led company, Humata is solely focused on solving the complexities of prior authorization. By seamlessly connecting payers and providers, we leverage deep clinical expertise and advanced AI to streamline approvals, reduce administrative burden, and ensure patients receive timely care. Our commitment to innovation is driven by real-world experience and a relentless pursuit of efficiency in healthcare.
"Automating prior authorization is a critical step towards improving revenue cycle management. It enables us to optimize operational workflows, reduce errors, and ultimately, deliver better financial outcomes for our organization while ensuring our patients receive the best possible care. When I think about Humata, I hone in on the 30% of referral volume they are automating so our staff doesn’t need to touch them.”
Allegheny Health Network
"Humata has enabled a new level of efficiency which has allowed us to work further days out than ever before - 45% are auto-completed. This is critical for procuring authorizations timely and limiting any negative impact to patient care. Humata's automation allows us to focus on the cases that require staff attention. The Al packaging feature allows us to quickly submit to the payer knowing that the right clinical information has been included in the bundle."
Renown Health
"The Humata Solution has allowed my team to work effectively and efficiently for our patients - 80% automation rate for statusing and 32% clinical bundles are unaltered. Many times, our staff are on the phone with patients and ordering providers, and because the automation handles the necessary tasks, my team can streamline their communications by sharing approvals or updates from the payer. This improves our relationship with patients and ordering providers, ultimately fostering trust in URMC for their medical imaging services."
University of Rochester Medical Center
"The partnership with Humata has been overwhelmingly positive (23 FTE reduction for referral management). For referrals, the big benefit is the administrative savings for not having to manually fax these requests to PCP’s. It is a big savings and it gets it in their hands more timely."
UHealth Miami
"By automating prior authorization imaging referrals we've not only streamlined our workflows but also significantly reduced the administrative burden on our staff (26% of referrals are auto-completed). This has allowed our team to dedicate more time and resources to high complex case reviews, leading to faster approval times and a substantial improvement in the overall patient experience. The impact of this partnership on our productivity has been wonderful."
Gundersen Health System
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