PriorAuthNow operates an integrated real-time prior authorization network that directly connects providers and payors and integrates with provider EHRs and payor case management systems. The platform enables "intelligent collaboration" to remove manual workflows, reduce back-and-forth, and accelerate time to decision and care. The company manages $61 billion in Provider Net Patient Revenue and reported over 300% growth in the past year. In a study cited by the company, clinical staff effort on prior authorizations was reduced by 91% (from 45 minutes to four), 25% of requests required no human effort, and overall turnaround time improved by 6.7 days. PriorAuthNow plans to use new funding to expand its network to additional providers and payors and to grow its team to meet rising market demand. The company recently announced a strategic alliance with Availity to help solve prior authorization at scale. PriorAuthNow provides an electronic prior authorization (ePA) SaaS solution that enables providers and payers to submit, monitor and complete prior authorizations and integrates with EMR systems and insurance carriers. The platform eliminates phone calls, faxing, and multiple payer portals to reduce administrative burden and improve patient care. In 2018 the company launched software with large provider clients in several states and currently serves 39 hospitals and health systems with more than 1,600 unique active users. Since the start of 2018 it has reduced turnaround times of client authorizations by more than 25 percent, and Q1 data shows 45 percent of requests requiring a decision were resolved within one business day. The company reported substantial revenue growth in 2018 and said it expects to triple revenue in 2019. Funds from the investment will be used to expand the team and advance operating capabilities, and the company expects to more than double staff in 2018. PriorAuthNow provides a secure software platform that simplifies how EHR systems connect with insurance carriers to submit, monitor and finalize prior authorizations. The platform is designed to eliminate lengthy phone calls, reduce the need to visit multiple payer sites, and avoid filling out many different authorization forms. The company is led by co-founder and CEO Joe Anstine. PriorAuthNow intends to use recently raised funds to expand its team and accelerate rollout of the platform to some of the largest hospital systems in the US. The product focuses on automating prior authorization workflows across the healthcare landscape. The company is based in Columbus, Ohio.

Total raised

$39M

Funding rounds

3

Latest round

Equity

Latest activity

Feb 2022