Prior authorization & UM · Touchless prior auth network
Rhyme
Rhyme (formerly PriorAuthNow) is a provider-payer prior authorization network that aims for touchless submission and status, with observation analytics and gold-carding tools. It is not a specialty-only PA portal for a single drug class.
Strong fit
- Large provider groups and health systems with high prior authorization volume whose payers are on the network
- Teams that want automatic submission and status checks across many payers, beyond a single specialty portal
- Buyers looking at gold-carding and tracking analytics with participating health plans
Weak fit
- Small clinics that need a simple specialty prior authorization tool without joining a network
- Organizations whose payers are not on Rhyme's connected network
- Buyers looking for a large utilization management policy engine for medical directors
Bottom line
Rhyme is worth considering for providers whose prior authorization problem is connecting to many payers and processing requests automatically. It suits organizations whose main payers and EHR are on its network. Specialty practices may prefer SamaCare, and teams needing phone follow-up should look at Infinitus.
Score breakdown
Weights: Outcomes 35% · Product 30% · Implementation 20% · Pricing clarity 15%.
Rhyme, formerly PriorAuthNow, automates prior authorization submission, tracking, and monitoring across a network of providers and payers.
Its gold-carding tools aim to remove unneeded authorizations over time. Rhyme says it handles millions of authorizations per year and covers a broad set of payers.
It is not a specialty-only portal or a payer policy engine.
Its value depends heavily on whether your main payers and EHR workflows connect to the network.
Ask for current volumes and a payer map for your mix. Prices are quoted for each customer.
Among the prior authorization tools we review, Rhyme scores below Infinitus and SamaCare. Its fit depends on the network, and its packages are less clear for mid-sized specialty clinics.
Confirm that your payers are connected before you commit.
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 | A prior authorization network linked to your EHR that connects providers and payers. Priced by quote. |
| What usually drives cost | Authorization volume, how many of your payers are connected, and EHR integration scope. |
| What to ask before you buy | Fees per authorization or for the platform for your top payers, with a written list of which payers are fully automatic today. |
| Published pricing | Rhyme does not publish prices. |
Prerequisites for purchase
| Need | Why it matters |
|---|---|
| What you need to get Rhyme to function | |
| A written list of your main payers and authorization volume | The network's value differs by payer. |
| An owner for EHR integration of submissions and status | Jumping between payer portals is what you want to stop. |
| Patient access staff to handle exceptions | Automation never covers 100% of cases. |
| A security review and BAA plan for payer connections | Joining the network stalls on paperwork. |
| Current authorization turnaround time by payer | Without a starting number, gold-carding claims cannot be checked. |
| What will maximize your value | |
| Confirm which of your payers are fully automatic | Overall coverage is not the same as coverage for your payers. |
| Track turnaround time and manual work rate by payer | Network averages hide gaps for your payers. |
| Pilot one service line before rolling out everywhere | Going live everywhere at once hides connection gaps. |
| Train staff on the tracking dashboards | Unused analytics do not remove authorizations. |
| Align with payer partners on gold-carding criteria | Hoping on your own is not a plan. |
| Deal-breakers | |
| Your top payers are not on the network. | |
| You need a simple specialty-only portal. | |
| No one has time for EHR integration. | |
| You will not assign staff to exceptions. | |
| Leaders expect all prior authorization work to vanish in the first month. | |
Value creation time frame
| # | Stage | Typical range |
|---|---|---|
| 1 | From signing to kickoff | 2-6 weeks for security review, EHR planning, and listing payers and drugs |
| 2 | From kickoff to first use | 4-12 weeks for the first specialty or site |
| 3 | From first use to steady results | 2-5 months before problem cases settle down |
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.