Prior authorization & UM · Touchless prior authorization
Humata Health
Humata Health makes AI software that gathers the clinical records a payer needs, matches them to payer policy, and submits and tracks prior authorization requests for health systems and payers.
Strong fit
- Health systems with large central authorization teams working imaging, procedure, and drug requests
- Billing leaders on Epic who want authorizations to start from the order itself
- Organizations that want one vendor with connections to both payers and providers
Weak fit
- Small practices with a few authorizations a week
- Buyers who want a long track record, since the company was founded in 2023
- Buyers who need a published price list
Bottom line
Humata Health is worth using for large provider organizations that want AI to handle prior authorizations from the order to the approval, often with no staff touch. It also serves payers. Specialty practices that want authorizations handled as a service may prefer Silna Health.
Score breakdown
Weights: Outcomes 35% · Product 30% · Implementation 20% · Pricing clarity 15%.
Humata Health, based in Winter Park, Florida, makes AI software that gathers the clinical records a payer needs, matches them to the payer's policy, and submits prior authorization requests.
Jeremy Friese, an interventional radiologist and former Mayo Clinic physician executive, founded it in 2023. He had founded Verata Health, an earlier prior authorization company that Olive bought in 2020. Humata added assets bought from other companies to build out its offering.
When a clinician places an order, Humata pulls the notes and results that match the payer's policy and flags gaps that could lead to a denial. It submits the request through the payer's portal or electronic connection and tracks it to a decision.
Staff see only the cases that need a person. It covers procedures, imaging, drugs, and referrals.
Large customers and investors have adopted it. Blue Venture Fund and LRVHealth led a $25 million investment in June 2024, with Optum Ventures, Highmark Ventures, and several health systems among its backers.
Allegheny Health Network, a Pittsburgh, Pennsylvania health system, automates more than 200,000 authorizations a year with Humata at a 96% first-pass approval rate. In 2025 it became the first health system to run authorizations from order to approval with no staff touch.
Optum launched Digital Auth Complete, built on Humata, for providers in February 2026. Since January 2026, Humata has also reviewed prior authorization requests for traditional Medicare in Oklahoma under the WISeR pilot run by the Centers for Medicare & Medicaid Services.
Other tools fit different setups. Rhyme suits a provider that wants authorizations handled with no staff touch through a payer network. Infinitus suits teams whose main burden is calls to payers.
Careviso suits work centered on lab and specialty tests. Silna Health suits a specialty practice that wants benefits checks and authorizations handled as a service, and Agadia or Banjo Health suit health plans.
Competitor landscape
| Vendor | Overall | Ease of implementation |
|---|---|---|
| Xsolis | 7.8 | 7.3 |
| Infinitus | 7.7 | 7.4 |
| Humata Health | 7.7 | 7.4 |
| Agadia | 7.6 | 7.2 |
| Careviso | 7.6 | 7.3 |
| Silna Health | 7.3 | 7.1 |
| Itiliti Health | 7.3 | 7.1 |
| Banjo Health | 7.2 | 7.0 |
| Hindsait | 7.0 | 6.7 |
| Rhyme | 6.5 | 6.3 |
Pricing
| Item | Detail |
|---|---|
| Model | Custom contract quoted by Humata Health. |
| What usually drives cost | How many authorizations you send, which services are covered (imaging, procedures, drugs, and referrals), the number of hospitals, and EHR connection. |
| What to ask before you buy | Whether pricing is per authorization or a platform fee, what share of your requests it expects to complete with no staff touch, and how it handles payers that only take faxes. |
| Published pricing | Humata does not publish a price list. |
Prerequisites for purchase
| Need | Why it matters |
|---|---|
| What you need to get Humata Health to function | |
| A leader for the central authorization team | This person owns the change in daily work. |
| EHR access for orders and notes | Requests start from the order. |
| Payer portal credentials | Submissions run through them. |
| Starting turnaround and denial rates | This shows change later. |
| Staff to review cases sent to people | Exceptions still need a person. |
| What will maximize your value | |
| Start with high-volume imaging | It has clear policies and many requests. |
| Track the share handled with no staff touch, by payer | This shows where to push next. |
| Add drugs and referrals after procedures | This builds on early wins. |
| Deal-breakers | |
| You send few authorizations a month | |
| There is no way to connect to your EHR | |
| No one owns the authorization team | |
Value creation time frame
| # | Stage | Typical range |
|---|---|---|
| 1 | Contract and EHR connection | 1-3 months |
| 2 | First services live | 2-4 months |
| 3 | More services and payers | 6-12 months |
Leadership
Methodology
| Weight | Factor | What it measures |
|---|---|---|
| 35% | Customer outcomes | Whether buyers get measurable operational or clinical-workflow results after go-live |
| 30% | Product | Capability depth, reliability, and fit for the job the category buys |
| 20% | Implementation | How hard it is to stand up, integrate, train, and stabilize |
| 15% | Pricing clarity | Whether a buyer can model total cost without a mystery quote |
| Label | Meaning |
|---|---|
| Highly recommend | Strong outcomes and product with manageable caveats |
| Recommend | Solid fit for the right buyer; know the tradeoffs |
| Conditional | Only with a specific use case or heavy caveats |
| Not recommended | Avoid for most buyers in this category |
Read our full methodology for how we weight scores and assign recommend labels.