Market maps/Prior authorization·Updated Oct 2026

Every company trying to fix prior authorization

We spend our days inside payer portals, so we keep a list of everyone working on fixing prior authorization. Here are 134 of them split into eight segments, placed by where the product starts. We noticed a few trends; roughly three companies per year were founded until 2020, after which the number tripled to around 11. Almost all of the new companies sell to providers.

companies: 134

New in 2025–26Showing 134 of 134

Provider-side automation

Submission, status, appeals and documentation for practices and health systems

Payer-side UM

Intake, criteria and decisioning for health plans

Informatics In Context

Delegated UM

The benefit managers who run prior auth on a plan’s behalf

Pharmacy ePA

Electronic PA for drugs, hubs and specialty access

Voice AI

Agents that sit on hold with the payer so staff do not

Clearinghouses and RCM

Where prior auth is one module among many

Optum (Change Healthcare)

Quadax

R1 RCM

SmarterDx (Thoughtful AI)

The SSI Group

Vyne Medical

Waystar

FHIR infrastructure

The rails for CMS-0057 electronic prior auth

EHR-embedded

Prior auth inside the chart

Legend: Launched or relaunched in 2025–26

Companies by founding year

Founding rate ran at about three a year from 2008 to 2020, then jumped to eleven a year from 2021 to 2024, with sixteen in 2023 alone. Provider-side automation is 30 of the 46 companies founded from 2022 to 2025 and all of the 2026 cohort. The newest payer-side and delegated UM companies were founded in 2023.

Provider-side automation
All other segments

133 of 134 companies have a founding year. 33 founded before 2008 are not plotted. 2026 is year to date, and the youngest companies are the hardest to find, so the last two bars undercount.