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Best Insurance Eligibility Verification & Prior Authorization Products

Best Insurance Eligibility Verification & Prior Authorization Products

Processes and tools that verify a patient's insurance coverage and obtain prior authorization for services.

Insurance Eligibility Verification & Prior Authorization: Products


47 products
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Rated In Top 10%
Rated In Top 10%
Versatile platform
Versatile platform
5+ years in business
5+ years in business
Rated In Top 10%
Rated In Top 10%
Versatile platform
Versatile platform
5+ years in business
5+ years in business

Valer’s technology speeds and simplifies prior authorization and referral management by automating submissions, status checking, verification, reporting, and EHR synchronization across all mid-to-large sized healthcare settings, specialties, and payers from one platform and portal.

All built just for you.

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product capabilities
Requirements Identification
Form Completion
Forms Library
Documentation Collection
Request Submission
Status Monitoring
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key clients
Leading Health System
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Leading Health System
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Leading Health System
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Leading Health System
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Product Logo
Rated In Top 10%
Rated In Top 10%
Versatile platform
Versatile platform
5+ years in business
5+ years in business
Rated In Top 10%
Rated In Top 10%
Versatile platform
Versatile platform
5+ years in business
5+ years in business

This solution automates the process of checking requests under review as well as continued status changes and updates. It supports many portals such as Evicore, Magellan, UHC and others. The solution includes business rules, exception handling and daily reporting functionality with customizable dashboard views. AI is also used to do analysis and supply predictive capabilities. The solution can also be hosted and supported by CampTek as an ongoing managed service.

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key clients
Leading Health System
Health system
Leading Health System
Health system
Leading Health System
Health system
Leading Health System
Health system
+50 verified clients
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Versatile platform
Versatile platform
5+ years in business
5+ years in business
Versatile platform
Versatile platform
5+ years in business
5+ years in business

Patient access departments are charged with accuracy from the start. 

Challenges—claims denials, returned mail, regulatory burdens and low patient satisfaction—are barriers they face. Solutions that empower registrars and staff with intuitive, consistent workflows and that prepare patients for their financial obligations have been elusive—until now.

True Access™ clearly and accurately fills the gaps in preservice coverage verification and estimation of patients’ financial obligations. Staff gain consistent workflows and patients receive precisely tailored payment options everywhere. True Access includes additional patient access tools for staff to support eligibility and address verification, medical necessity and prior authorization processes.

With True Access from RevSpring, you receive proven solutions that support four critical areas: 

(1) Coverage Determination and Verification,

(2) Claim Denial Prevention,

(3) Patient Financial Readiness and Increased

Collections, and

(4) Tools, Workflows and Reporting for Staff.

Coverage Determination & Verification

Fast, simple and accurate resolution of all patient accounts prior to, or at the point of, service—no matter whether or not patients are insured, uninsured, underinsured and/or qualify for financial assistance. Includes Eligibility, Coverage Verification and Determination, and Medicaid Coverage Discovery.

Claim Denial Prevention

True Access reduces time spent rebilling claims and reduces days in AR by submitting claims correctly from the start. Includes Prior Authorization and Precertification, Medical Necessity and Coordination of Benefits.

Patient Financial Readiness & Increased Collections

Prepare patients for their financial responsibility and empower them to pay precisely what they can, when they can, from anywhere. Accurate estimates, seamlessly 

integrated with RevSpring’s PersonaPay portal, enable patients to manage their balances with confidence. Our hassle-free billing adjustment solution also allows 

providers to confidently request payments in advance.

Tools, Workflows & Reporting for Staff

True Access empowers staff with intuitive workflows and a modern user interface to manage registration quickly and efficiently. Intuitive staff views based on work queues and guided workflows drive consistency and accuracy, saving time for patients and staff. Our tools also allow you to monitor staff performance.

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key clients
Leading Health System
Health system
Leading Health System
Health system
Leading Health System
Health system
Leading Health System
Health system
+50 verified clients
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Product Logo
Rated In Top 10%
Rated In Top 10%
Versatile platform
Versatile platform
5+ years in business
5+ years in business
Rated In Top 10%
Rated In Top 10%
Versatile platform
Versatile platform
5+ years in business
5+ years in business

Direct is the leading EHR-integrated cost transparency solution. The solution brings real-time, pharmacy benefit cost information, coverage restrictions, and alternatives into native EHR workflows. Giving providers cost information at the point-of-care enables data-driven and evidence-based decisions that help patients get the care they need at prices they can afford.

Features and Benefits:

 - Access to lower-cost alternatives increases care adherence and patient health and satisfaction

 - Select medications that do not require prior authorization

 - Reduced pharmacy/PBM/payer call-backs, prior authorization denials, and other uncompensated provider hassles

 - Uses native order workflows, is easy to implement

- Surfaces pharmacy alternatives to drive continuity of care and patient satisfaction

- Integrates patient affordability program offerings into RTPB results, showing best-cost options when insurance coverage isn't found or doesn't apply. 

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key clients
Leading Health System
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Leading Health System
Health system
Leading Health System
Health system
Leading Health System
Health system
+50 verified clients
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Versatile platform
Versatile platform
5+ years in business
5+ years in business
Versatile platform
Versatile platform
5+ years in business
5+ years in business

Lose the work your heart's not in!

Whether you're a payer processing claims forms or a provider charting during your off hours, the administrative burden in healthcare is high. But when the work you want to do is buried under the work you have to do, don't lose heart.

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key clients
Leading Health System
Health system
Leading Health System
Health system
Leading Health System
Health system
Leading Health System
Health system
+50 verified clients
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Versatile platform
Versatile platform
Versatile platform
Versatile platform

Agentic AI employees for healthcare

Explore our custom AI employees for critical back office, revenue cycle, and administrative healthcare workflows. Some of our most popular include full automations for:

  1. Prior authorizations
  2. Claims processing
  3. Insurance verification
  4. Payment posting
  5. Patient enrollment
  6. Denial management
  7. Claim scrubbing
  8. Credentialing
  9. Charge reconciliation

How Magical works

Fully automate rev cycle workflows

Use an AI employee trained specifically in revenue cycle management to automate entire processes end-to-end. (No human oversight required.)

Lower your cost to collect

Unlock the efficiency of a machine. Magical pulls patient patient data directly from one system into another, to minimize insurance denials and delays.

Built for enterprise security

Maintain the highest levels of security and privacy. We never store any personal health info on our servers. 

Daily Automated Testing | Automation Logs | SOC2 & HIPAA Compliant

Best-in-class reliability

Get over 90% success rates on end-to-end automations of any complex workflow. Magical uses multi-agent evaluation infrastructure to ensure your automations are running smoothly. 

Performance monitoring

Dive into complete logs of every single step of every single automation to give your team clear visibility into success rates and edge cases. 

Who we are

A blended team of 40+ technology and healthcare experts. Not only will you be working with agentic AI engineers, but also seasoned rev cycle experts. 

Why we’re trusted

Over 100,000+ companies—including WebPT, Phreesia, SonderMind, and Curalta—trust Magical automations for the following reasons:

  1. Fast: 1 week average implementation time
  2. Reliable: 90%+ average success rate end-to-end
  3. Proven: 100% agentic automation (no bots)
  4. Scalable: Magical runs entirely on virtual machines
  5. Interoperable: Magical can rapidly integrate with any system
  6. Compliant: Magical is SOC 2 and HIPAA-compliant
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product capabilities
Intelligent Automation
Compliance and Security
Real-Time Eligibility and Benefits Verification
Denial Management and Prevention
Status Monitoring
Request Submission
Documentation Collection
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key clients
Leading Health System
Health system
Leading Health System
Health system
Leading Health System
Health system
Leading Health System
Health system
+50 verified clients
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Versatile platform
Versatile platform
Versatile platform
Versatile platform

Optimize your policy management.

The Most Comprehensive Database

Access the most complete database of live and historical medical and pharmaceutical policies and related documents on the market.

Real-Time Notifications

Stay ahead with email alerts on any changes to medical and pharmaceutical policies by payer and therapy, allowing you to respond swiftly to developments that may impact your stakeholders.

Central Access

Effortlessly search and review Medical & Pharmacy policies, draft policies, prior authorization documents, coding guidelines, reimbursement updates, and more—all in one centralized location.

Comparison View

Easily identify differences between current and historical versions using our intuitive viewer that highlights changes for quick reference.

Research Control

Focus your research by filtering specific payers, plan types, states, therapies, devices, or document types, ensuring you find exactly what you need.

Visit https://www.policyreporter.com/industry/providers/ for more information and a free trial.

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key clients
Leading Health System
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Leading Health System
Health system
Leading Health System
Health system
Leading Health System
Health system
+50 verified clients
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Versatile platform
Versatile platform
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Versatile platform
Magical’s Prior Authorization Agent is an advanced agentic AI solution purpose-built to automate the full prior authorization workflow—reducing delays, manual effort, and denials that burden providers and revenue cycle teams. Designed to act like a digital employee, the solution intelligently extracts clinical documentation from EMRs, determines the appropriate payer-specific requirements, completes the necessary forms, and submits them through the correct channels, whether by API, portal, or fax. Unlike traditional automation tools that rely on static rules or templates, Magical’s agentic AI operates with reasoning and adaptability. It can navigate unstructured systems, manage edge cases, and respond to real-time payer feedback without requiring human oversight. Once submitted, the agent continuously monitors the status of each request, follows up as needed, and flags any denials or exceptions that may require staff intervention. The result is a dramatic improvement in operational efficiency and patient access to care. Organizations using Magical’s Prior Authorization Agent have seen faster turnaround times, reduced administrative burden, and improved clean submission rates. By automating repetitive and error-prone tasks, it frees staff to focus on higher-value work and enhances the patient experience. Magical’s Prior Authorization Agent is easy to deploy, EMR-agnostic, and scalable across service lines. It brings together powerful AI, healthcare-specific workflows, and continuous learning to deliver consistent results in even the most complex payer environments. Whether your goal is to reduce cost, speed up access, or improve accuracy, Magical delivers automation that thinks, acts, and delivers—like your best employee, 24/7.
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key clients
Leading Health System
Health system
Leading Health System
Health system
Leading Health System
Health system
Leading Health System
Health system
+50 verified clients
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Versatile platform
Versatile platform
Versatile platform
Versatile platform

DataMartrix Medical's prior authorization services are perfect for those practices backed up by the burden of prior authorizations and are not reimbursed promptly. We will handle PAs throughout the entire process. We can work alongside current staff to support orders, submissions, approvals, and the denial/appeal process or handle the whole process to free up time for you and your staff.

Our HIPAA-compliant and secure service is EHR and EMR agnostic, so we can work with any system with a minimum setup cost that is, on average, 70% less than AI-centered RCM tools and 50% less than an hourly employee. DataMatrix is 99+% accurate and offers 24/7 capabilities, so there is no downtime. The prior authorization service by DataMatrix Medical accommodates all private insurance, no-fault, and worker's comp.

For over 25 years, DataMatrix Medical has been a leader in healthcare business process support. The prior authorization product can work seamlessly with other products, such as medical scribing, document indexing, and medical credentialing.

Try the DataMatrix Medical prior authorizations service risk-free and no long-term contracts; cancel anytime.

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key clients
Leading Health System
Health system
Leading Health System
Health system
Leading Health System
Health system
Leading Health System
Health system
+50 verified clients
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Versatile platform
Versatile platform
5+ years in business
5+ years in business
Versatile platform
Versatile platform
5+ years in business
5+ years in business
When you’re serious about achieving the best possible outcome, you go to a specialist. Nearly a decade and a half ago AccuReg began its specialized focus and quickly became the industry authority on optimizing the power and potential of the hospital RCM front-end. Since Day One we’ve known that improving front-end processes in a hospital’s Patient Access department is the gateway to more net revenue, lower costs, enhanced patient satisfaction and many other benefits.
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key clients
Leading Health System
Health system
Leading Health System
Health system
Leading Health System
Health system
Leading Health System
Health system
+50 verified clients
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