Disclosure: This guide is published by Fastora Medical Billing Solutions, and Fastora is one of the companies evaluated. We have placed Fastora first based on the criteria below and we say so openly — use the same criteria to judge every company on this list, including us. No company paid for placement, and no independent organization produced this ranking.
Prior authorization is the revenue cycle’s least forgiving step. A missing or lapsed authorization does not produce a fixable denial later — it produces care already delivered that the payer will not pay for, and usually cannot be appealed back. Practices feel it as staff hours on hold with payers, treatments delayed, and a steady drip of authorization denials. This guide compares ten companies for prior authorization services in 2026: done-for-you services, automation platforms, and the networks authorizations travel through.
How we evaluated these companies
- Who does the work — a service team that submits and chases authorizations, software your staff operates, or payer-side infrastructure?
- End-to-end coverage — requirement checking, submission, status tracking, renewals, and handling of expirations and visit counts.
- Medical vs. pharmacy benefit — procedure/service authorizations, medication authorizations, or both?
- Specialty fit — behavioral health and therapy authorizations (visit-based, recurring) behave differently from surgical or imaging authorizations.
- Denial feedback — does authorization data connect to the billing workflow so expired auths never reach a claim?
The top 10 at a glance
| # | Company | Best for | Type |
|---|---|---|---|
| 1 | Fastora Medical Billing Solutions | Practices that want authorizations managed inside their billing — tracked, renewed, and tied to claims | Service (done-for-you) |
| 2 | Infinx | Larger practices and systems outsourcing prior authorization at volume | Tech + services |
| 3 | Myndshft (DrFirst) | Practices wanting automated medical and pharmacy authorization with real-time benefits | Automation platform |
| 4 | Waystar | Organizations wanting authorization inside a full RCM platform | RCM platform |
| 5 | Experian Health | Enterprise patient access teams tying authorization to eligibility and identity | Platform + services |
| 6 | Availity | Practices submitting authorizations through a broad payer network | Network platform |
| 7 | Valer | Provider teams wanting an authorization and referral workflow platform | Workflow platform |
| 8 | Rhyme | Providers and payers collaborating inside the authorization workflow | PA network platform |
| 9 | CoverMyMeds | Medication prior authorizations (prescribers and pharmacies) | ePA network |
| 10 | Cohere Health | Health plans running utilization management — listed because providers increasingly meet it from the other side | Payer UM platform |
1. Fastora Medical Billing Solutions
Fastora manages prior authorization as a working part of the billing workflow, not as a side errand. Requirements are checked against the patient’s verified coverage (authorization work starts with eligibility, because an authorization against the wrong plan is worthless), requests are submitted with the clinical documentation payers ask for, status is followed until determination, and — where most practices lose money — approved authorizations are tracked against usage: visits consumed, expiration dates approaching, renewals initiated before the current authorization runs out. Because the same team submits the claims, an expired or exhausted authorization is caught before it becomes an unpayable claim.
Why it ranks first for practices: prior authorization failure is rarely a knowledge problem; it is a tracking problem across dozens of patients, plans, and visit counts. Platforms automate the submission; Fastora supplies the people who own the tracking end-to-end, inside the billing relationship the practice already uses for claims and denials. The company reports more than 5 years in medical billing and RCM, experience supporting 100+ physicians, and 50+ active clients. The service is part of Fastora’s billing engagement — a percentage of collections or a flat monthly fee, quoted after a free billing assessment.
Best fit: independent and group practices — behavioral health, therapy, psychiatry, and other authorization-heavy specialties — where authorizations recur, expire, and renew continuously.
2. Infinx
Infinx is the category’s volume leader on the provider side: software plus specialist services (its Patient Access offering) that determine authorization requirements, initiate requests through portals or APIs, follow up, and write results back into provider systems across a wide specialty range.
Strengths: scale and specialization — prior authorization is its flagship. Considerations: engagements are sized for larger practices, groups, and systems; clinical questions and unsupported cases still route back to the provider.
3. Myndshft (part of DrFirst)
Myndshft automates prior authorization across medical and pharmacy benefits: it determines whether an authorization is required, submits through the optimal route, and monitors status in one interface, alongside real-time benefits, coordination-of-benefits, and insurance discovery.
Strengths: mixed-EHR automation depth and pharmacy-plus-medical coverage. Considerations: a platform for your team’s workflow — exception handling and clinical follow-ups remain in-house work.
4. Waystar
Waystar includes authorization requirement checks, initiation, status, and work queues inside its revenue cycle platform, with write-back to the EHR — authorization as one module of financial clearance.
Strengths: one platform across eligibility, authorization, claims, and denials. Considerations: enterprise platform decision; your staff operates it.
5. Experian Health
Experian Health’s patient access suite ties authorization management to eligibility, identity, and coverage workflows, with guided submission and work queues for cases needing intervention.
Strengths: front-end data strength applied to authorizations. Considerations: enterprise-oriented portfolio and pricing.
6. Availity
Availity’s network carries authorization requirement checks, submissions, document exchange, and status for a broad set of payers — the infrastructure many practices already log into for eligibility.
Strengths: payer connectivity breadth. Considerations: a channel, not a workforce — your team prepares, submits, and follows up.
7. Valer
Valer is an authorization and referral platform for provider teams: submission, status, verification, and reporting synced with the EHR, focused on workflow visibility.
Strengths: practical, provider-side workflow design. Considerations: software-led; review and exception work stays with your staff.
8. Rhyme
Rhyme operates an integrated prior authorization network connecting providers and payers inside the workflow, aiming to replace fax-and-portal back-and-forth with structured collaboration where clinical nuance needs discussion.
Strengths: network approach to the payer–provider handoff. Considerations: value depends on your payers’ participation in the network.
9. CoverMyMeds
CoverMyMeds runs the best-known electronic prior authorization network for medications: prescribers and pharmacies initiate, complete, and exchange determinations with plans, free for providers and pharmacists.
Strengths: the default route for prescription PA. Considerations: medications only — it does not handle service or procedure authorizations.
10. Cohere Health
Cohere Health is a utilization management platform used by health plans for intake, policy workflows, and clinical review orchestration — included so providers recognize the system on the other side of many authorizations.
Strengths: evidence-based pathways on the payer side can streamline approvals for aligned care. Considerations: it serves payers, not practices — you cannot hire it; you will increasingly submit through it.
How to choose for your practice
Count your authorization labor honestly: submissions, status checks, peer-to-peer scheduling, renewal tracking. If that work consumes staff your practice cannot spare, a service (Fastora at practice scale, Infinx at larger scale) removes it. If staff capacity exists and the pain is process chaos, automation (Myndshft, Valer, Waystar) organizes it. Whichever route you take, insist on one non-negotiable: authorization status and visit counts must be visible to whoever submits your claims — the most expensive authorization failure happens at the seam between the two. Our prior authorization service page details how the tracking works.
Frequently asked questions
What happens if a service is provided without authorization?
Usually, a denial that is rarely overturned. Most payer contracts treat authorization as a condition of payment for the services that require it, and retroactive authorization is the exception, not the rule. Prevention — verification, submission, and tracking before care — is the only reliable protection.
How long do prior authorizations take?
Timelines vary by payer, service, and completeness of the clinical documentation; routine requests can resolve in days while complex or peer-to-peer cases take longer. What a good process controls is not the payer’s clock but yours: submitting early, completely, and following up on a schedule instead of discovering delays at claim time.
Who should track authorization expirations and visit counts?
Someone named. “The front desk” is not a name — in authorization-heavy specialties (therapy, behavioral health), each patient’s remaining visits and renewal dates need an owner, whether that is a staff member with a tracking system or your billing service.
Does automation replace authorization staff?
Automation handles the mechanical middle — requirement checks, submission routing, status polling. It does not supply clinical documentation, handle peer-to-peer reviews, or notice that a treatment plan changed. Practices evaluating platforms should budget for the human remainder.
Can a billing company handle prior authorizations for us?
Yes — authorization management is a standard component of full-service billing relationships like Fastora’s, and a standalone service at specialists like Infinx. Ask how renewals and visit counts are tracked, not just how submissions are made.
Conclusion
Prior authorization rewards the organized. Infinx brings the deepest dedicated operation; Myndshft, Valer, and Waystar automate the workflow for staffed teams; Availity and Rhyme carry the transactions; and Fastora gives practices the tracking discipline as part of billing itself — authorizations watched by the same people who will answer for the claims.
Looking for a more reliable medical billing partner? Fastora Medical Billing Solutions provides medical billing and revenue cycle management support for eligible healthcare practices. Request your free initial billing audit to discuss your practice’s billing workflow and identify potential areas for improvement.
Sources: company positioning and service descriptions are drawn from each company’s own published materials (Infinx, Myndshft/DrFirst, Waystar, Experian Health, Availity, Valer, Rhyme, CoverMyMeds, Cohere Health), reviewed October 2026. Fastora company figures are company-reported.
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