9 Best prior authorization software platforms in 2026

Key takeaways

Software covered: 1. Pabau, 2. CoverMyMeds, 3. Surescripts, 4. Availity, 5. Waystar, 6. Infinx, 7. Myndshft, 8. Rhyme, 9. Silna Health.

Prior authorization software splits into drug benefit networks and medical benefit automation, and a tool built for one side will not cover the other.

The CMS prior authorization rule excludes drugs, so its 2026 deadlines tighten procedure approvals and leave prescription approvals exactly where they are.

Pabau is the only platform here that publishes a price, at $62 a month for one user with every feature included.

CoverMyMeds and Availity Essentials cost providers nothing, because health plans and pharmacy benefit managers fund the network instead.

Winning the approval is half the job. Check that the authorization number reaches the appointment and the claim, or the write-off lands anyway.

The best prior authorization software for your practice comes down to one question. Are you authorizing prescriptions, or procedures and services? Those two jobs run on different networks, and a tool built for one rarely touches the other.

The burden itself is not in dispute. Practices complete 39 prior authorization requests per physician each week, and staff spend 13 hours on them. Those figures come from the AMA’s 2025 prior authorization physician survey.

This guide reviews nine platforms for private practices, med spas, therapy practices, and larger provider groups. Every price below came off the vendor’s own site in August 2026, never a review aggregator. Only one of the nine publishes a figure at all.

9 Best prior authorization software platforms compared at a glance

Pabau, our own platform, tops the list; the other eight run drug benefit networks first, then medical benefit automation. Read the “what it authorizes” column first, because it rules most of the list out for you.

What does prior authorization software do?

Prior authorization software asks the payer for approval before you deliver care, then tracks the answer. It automates the prior authorization process your staff runs by phone and fax today. The good ones do four separate jobs, and most tools are strong at two of them.

• Determination: Checking whether this service, for this plan, needs an authorization at all. Infinx puts its determination agent at over 98% accuracy against payer guidelines and the CPT code.
• Submission: Sending the request with the clinical documentation attached, electronically rather than by fax or portal login.
• Status and follow-up: Chasing the payer and surfacing the decision, the approved date range, and the approved unit count.
• Carrying the result forward: Getting the authorization number onto the appointment and onto the claim. This is the step most vendors leave to you.

That last job is where money leaks. An approval that never reaches the claim form produces the same denial as no approval at all. The payer books that denial as a contractual write-off rather than a patient balance.

Those rejections come back under specific denial codes, and the authorization ones are easy to spot once you know them.

The three categories, and what each authorizes

Prior authorization tools fall into three groups: drug benefit networks, medical benefit automation, and approvals held inside your practice management system. The category decides what the tool can authorize, so it matters more than any feature list.

Drug benefit networks live in the e-prescribing workflow. CoverMyMeds and Surescripts move a request to the pharmacy benefit manager and bring back a decision, often in minutes. Neither one will authorize an infusion, a course of therapy, or a surgical procedure.

Medical benefit automation handles the rest. Availity, Waystar, Infinx, Myndshft, Rhyme, and Silna Health submit to the health plan for imaging, surgery, therapy, and in-office drugs billed under the medical benefit. Most of them are sold to health systems and large groups.

Practice management platforms authorize nothing themselves. Practice management software like Pabau instead keeps the result. The approved number, dates, and unit count sit on the client record, the appointment, and the insurance claim. So the approval you won gets used before it expires.

There is a fourth group worth naming, because listicles keep putting it in the buyer’s column. Cohere Health sells to health plans, not to practices. Your staff may submit through it, but no practice can purchase it.

The PA mix test

Before you take a single demo, run the PA mix test on last month’s authorizations. The test takes about 20 minutes and eliminates most of the shortlist above. Pull the requests from your submission log, or from a stack of completed prior authorization forms if you still work on paper.

1. Count and split. Pull every authorization your practice requested last month. Sort each one into prescriptions on the drug benefit, or procedures and services on the medical benefit.
2. Buy for the larger half. If prescriptions dominate, start with a drug benefit network, and CoverMyMeds costs you nothing. If procedures dominate, you are shopping in the medical benefit column.
3. Then check the handoff. Ask each vendor where the approved number, date range, and unit count end up. If the answer is a separate portal, someone in your practice retypes it onto the claim.

The nine platforms, reviewed in rank order

Each platform below was assessed on what it can authorize, how it reaches your existing systems, published pricing, verified review data, and best-fit practice size. Ratings come from Capterra and G2 where a public profile exists, and five of the nine have none.

Pabau, our own platform, leads the list; the rest follow in the order they request and win approvals from a payer.

1. Pabau – best for keeping a won approval on the claim

Pabau is an all-in-one practice management system built for medical aesthetics, wellness, and private healthcare. It leads this list because of what happens after the approval: the eight platforms below request and win approvals from payers, and Pabau is where that result gets used.

Pabau holds the result instead: insurer, policy details, and authorization code live on the client record, and Pabau’s claims management software validates those fields before a claim can go out.

That step matters because of how authorizations fail: the approval is won, the visit gets rescheduled past the approved date range, and nobody notices until remittance. Pabau ties the authorization to the appointment instead.

Key features

• Authorization details on the client record: Insurer, policy, membership number, and code stored against the patient
• Claim validation before submission: Flags a missing membership or authorization code
• Direct claim connections: Via Claim.MD in the US, with regional connections in the UK and Australia
• One claims dashboard: Pending, submitted, processing, paid, and error status by date or insurer
• Mixed revenue billing: Insurance claims and private-pay invoices in one ledger
• Clinical record in the same place: Treatment notes, consent forms, and photos on the visit

Where Pabau shines

• The handoff nobody else covers: Every other tool ends at the payer’s decision; Pabau carries it to the invoice.
• Mixed revenue practices: Handles insured and self-pay halves of aesthetic billing in one ledger.
• No feature gating: Claims, clinical records, scheduling, and marketing sit in every subscription.
• One vendor instead of five: Fewer agreements, one login for your team.

Where Pabau falls short

• Not an ePA hub: Electronic requests at hundreds of payers is a job for CoverMyMeds, Availity, or Waystar.
• Wrong shape for hospitals: Built for practices and groups, not a health system running Epic across 40 service lines.
• Setup takes time: Structured onboarding with a dedicated coordinator, not self-serve signup; expect a few weeks to go live.

Customer reviews

Pabau scores 4.7 out of 5 from 647 reviews on Capterra, the highest verified rating here. Reviewers praise the all-in-one scope; criticism covers the learning curve and slow loading.

Who Pabau is best for

• Med spas and aesthetic practices billing a mix of insurance and private pay
• Wellness, IV therapy, and weight loss practices billing against a booked treatment
• Private practices tired of reconciling a portal against a separate billing system
• Multi-location groups wanting one record per patient, every site

Pricing

Pricing depends on location and user count, and annual billing saves up to 20%. Every plan carries claims, clinical records, and scheduling, so no feature sits behind a higher tier.

2. CoverMyMeds – best for prescription authorizations at no cost

CoverMyMeds is the electronic prior authorization network most US practices already touch, owned by McKesson, handling prescription authorizations across most health plans and pharmacy benefit managers.

It stays free for providers and pharmacists, funded by plans, PBMs, and manufacturers, with a network naming more than a million providers, 50,000 pharmacies, and 350 EHR systems.

A pharmacy can also start a request and route it to you, removing the initial phone call. CoverMyMeds will not authorize a procedure, a course of therapy, or an in-office infusion billed on the medical benefit.

Key features

• Electronic prior authorization: Request, question set, and decision handled online
• Pharmacy-initiated requests: The pharmacy can start the request and pass it on
• Broad EHR reach: Hundreds of EHR systems, or the free web platform
• Prior authorization forms library: Plan-specific forms retrieved automatically
• Status tracking: Approvals, denials, and information requests in one queue

Where CoverMyMeds shines

• Cost: No provider-side fee at all.
• Reach: Few drug plans sit outside the network.
• Specialty medication support: Useful for biologics and other high-denial prescriptions.

Where CoverMyMeds falls short

• Drug benefit only: Procedures, imaging, therapy, and medical-benefit infusions are out of scope.
• Interface age: G2 reviewers rate it 3.7, the lowest score here, and flag a dated interface.
• Another system to reconcile: The approval lands in CoverMyMeds, not your appointment or claim.

Customer reviews

CoverMyMeds Platform holds 3.7 out of 5 from 16 reviews on G2, a thin sample for a network this large, and no Capterra or Trustpilot profile exists.

Who CoverMyMeds is best for

• Any US practice sending prescription authorizations, any size
• Specialty prescribers dealing with biologics and high-cost medications
• Practices whose EHR lacks built-in electronic prior authorization

Pricing

CoverMyMeds states on its own support pages that provider and pharmacist access is free, funded by health plans, PBMs, and manufacturers. There is no published price list, because a practice is not the customer.

3. Surescripts – best for prior authorization inside your existing EHR

Surescripts is the network layer behind electronic prescribing in the US, reaching prescribers through EHR vendors. It reports that 84% of prescribers use an EHR equipped with electronic prior authorization.

Electronic Prior Authorization delivers the plan-specific question set into the prescribing screen, with under four minutes to return the average approval. Prior Authorization Automation goes further, pulling clinical answers straight from the record.

Surescripts reports a median approval time of 18 seconds on that automated path, with 11% fewer denials for missing information. The practical question is whether your EHR vendor has switched it on.

Key features

• In-workflow question sets: Plan and drug-specific questions delivered inside the EHR
• Automated data retrieval: Answers the question set from the patient record
• Task routing: Rules that let staff manage requests for a prescriber
• Prior Authorization Portal: A web route where the EHR lacks the integration
• Renewals: Automatic renewal requests on ongoing therapies

Where Surescripts shines

• Zero extra software: The prescriber never leaves the EHR.
• Speed: 10 minutes of active work removed per authorization, Surescripts reports.
• Patient wait times: More than two days saved.

Where Surescripts falls short

• Not yours to buy: Coverage arrives with your EHR contract.
• Prescriptions only: No medical benefit support.
• No published pricing: The site quotes no figure.

Customer reviews

Surescripts Prior Authorization carries no verified aggregate rating on Capterra or G2, normal for infrastructure sold to EHR vendors rather than practices. Ask your own EHR vendor which Surescripts products your license includes.

Who Surescripts is best for

• Practices on a major EHR that already includes electronic prior authorization
• High-volume prescribers who want approvals handled without a second system
• Practices comparing EHR vendors, where ePA support is a contract question

Pricing

Surescripts publishes no pricing and directs every enquiry to sales. Ask your EHR vendor, since that is where the cost, if any, sits.

4. Availity – best free multi-payer portal for medical authorizations

Availity is the multi-payer portal a US billing team most often lives in, and its site describes Essentials as a free portal, reporting 95% direct payer connectivity and 3 million connected providers.

Instead of logging into six plan portals, staff request and track medical authorizations in one place, alongside eligibility and claim status. Participating plans vary by region, so check yours first.

Availity also sells Essentials Pro and an AI-assisted utilization management product, AuthAI, sold to health plans, not practices.

Key features

• Multi-payer authorization requests: Submit and track medical authorizations from one login
• Free Essentials tier: Availity describes the standard account as a free portal
• Eligibility and benefits: Real-time and batch checks in the same workflow
• Essentials Pro: Adds denial management, financial clearance, and EHR authorization
• Clearinghouse network: Claims and remittance over the same connections

Where Availity shines

• Free at the point of use: Costs a practice nothing, rare in the medical benefit column.
• Fewer logins: One portal replaces a browser full of plan sites.
• Regulatory readiness: Availity markets a CMS-0057-F suite, rebuilding connections for the new APIs.

Where Availity falls short

• Coverage is uneven: Which plans you reach depends on region and payer mix.
• Still a portal: Staff work in a browser tab, then retype the result into your system.
• Quote-only upgrade: Essentials Pro publishes no price, so the step up from free is unknown until you call.

Customer reviews

Availity averages 4.0 out of 5 from 41 reviews on G2. Reviewers value one portal for many payers; complaints cluster on payer coverage and a dated feel.

Who Availity is best for

• Practices whose staff log into several payer portals a day
• Billing teams wanting eligibility, authorizations, and claim status together
• Groups large enough to justify Essentials Pro and EHR integration

Pricing

Availity’s own login page calls Essentials a free portal, and no price is published for Essentials Pro.

5. Waystar – best for hospital and multi-site revenue cycle teams

Waystar sells authorization automation as part of a revenue cycle platform, the right shape when authorizations are one team’s full-time job, reporting 70 million authorization transactions a year and coverage across 35 or more service lines.

Authorization Manager runs the workflow, Auth Initiate opens requests for scheduled services, Auth Status chases updates, and Medical Necessity checks the order against payer policy.

Waystar also markets Auth Accelerate for end-to-end automation, reporting a 70% cut in submission time and 85% auto-approval from implemented clients — vendor figures, so treat them as a target, not a guarantee. Our Pabau versus Waystar comparison covers the claims side.

Key features

• Authorization Manager: Determination, submission, and status tracking in one queue
• Auth Initiate and Auth Notify: Separate paths for scheduled services and admissions
• Medical necessity checking: Orders tested against payer policy before submission
• AltitudeAI: AI across the revenue cycle, including appeal drafting for denials
• Denial and claim management: Authorizations sit beside the claims they affect

Where Waystar shines

• Depth on the medical benefit: Broader coverage than any portal-based option here.
• Authorizations next to denials: The same platform handles the appeal on a failed request.
• Verified review base: 207 Capterra reviews, the second-largest sample here.

Where Waystar falls short

• Wrong scale for a small practice: Case studies are health systems, not three-room practices.
• No published price: Every route ends at a demo request.
• Vendor-reported outcomes: Automation figures come from Waystar’s own client data, not independent study.

Customer reviews

Waystar scores 4.4 out of 5 from 207 reviews on Capterra and 4.4 from 117 on G2. Reviewers rate the platform’s breadth highly; value for money scores lowest, at 4.2.

Who Waystar is best for

• Hospitals, health systems, and large specialty groups
• Organizations with staff dedicated to authorizations and denials
• Practices already running Waystar for claims and remittance

Pricing

Waystar publishes no prices. Expect the quote to scale with transaction volume and the modules you take.

6. Infinx – best for imaging and high-volume procedure authorizations

Infinx pairs authorization automation with a staffed service, the honest answer to why full automation stalls: complex cases and payers who refuse electronic submission still need a person, and Infinx supplies one.

The determination step is strongest. Infinx quotes over 98% accuracy deciding whether an authorization is needed, judged against payer guidelines and the CPT code, flagging requests needing none instantly.

Infinx lists 2,800 or more payer connections and integrations with Epic, Cerner, ModMed, and NextGen. Its case studies are health systems and imaging networks — the intended buyer.

Key features

• Authorization determination agent: Decides whether a service needs authorization, at over 98% accuracy
• Initiation and follow-up agents: Electronic submission, then status chasing with EHR updates
• Human exception handling: Specialists work cases automation cannot close
• Broad EHR integration: Connections via HL7, X12, APIs, and RPA
• Machine learning on your data: Denial risk and turnaround prediction that improves with volume

Where Infinx shines

• The hybrid model: You are not left holding the cases software could not finish.
• Determination accuracy: Knowing early no authorization is needed lets you book sooner.
• Specialty depth: Strongest in radiology, orthopedics, cardiology, and infusion therapy.

Where Infinx falls short

• No verified reviews: No aggregate rating on Capterra or G2 to check against the pitch.
• Service pricing is opaque: A staffed model means cost depends on volume, and nothing is published.
• Enterprise fit: A single-location practice is not the target customer.

Customer reviews

Infinx Prior Authorization has no verified aggregate rating on G2 or Capterra. Ask for references in your own specialty and volume.

Who Infinx is best for

• Imaging centers, radiology groups, and diagnostic labs
• Orthopedic, cardiology, and infusion practices with steady authorization volume
• Groups that want to keep their own staff and add capacity rather than outsource

Pricing

Infinx publishes no prices and quotes after a consultation. The site offers a prior authorization ROI calculator.

7. Myndshft – best for infusions and in-office injectables

Myndshft solves the awkward middle of the split: a drug given in your treatment room is usually billed on the medical benefit, not the drug benefit. CoverMyMeds cannot help there, and a general medical tool often lacks the drug detail.

Myndshft covers both sides, reporting real-time benefit verification for 94% of covered lives, and also handles coordination of benefits, insurance discovery, and patient out-of-pocket calculation. DrFirst acquired Myndshft in April 2024, and the product now sits inside that company.

For an IV therapy, weight loss, or hormone practice billing insurers, this is the most relevant category here: the authorization and benefit check land together, so you know the patient’s balance before treatment.

Key features

• Medical and pharmacy authorizations: One platform for both benefit types
• Real-time benefit verification: Patient-specific eligibility for 94% of covered lives
• Coordination of benefits: Secondary payers identified in real time
• Insurance discovery: Active coverage found for patients arriving without details
• Patient financial responsibility: Out-of-pocket cost calculated before treatment

Where Myndshft shines

• In-office drugs on the medical benefit: No other platform here targets that combination directly.
• Benefit check with the authorization: Coverage, secondary payer, and patient balance in one pass.
• Specialty medication focus: Built around infusions and injectables, the heaviest authorization load.

Where Myndshft falls short

• Acquisition risk: DrFirst owns the product now, so the roadmap answers to a larger portfolio.
• No verified reviews: No aggregate Capterra or G2 rating.
• Narrow fit: Wrong tool if you do not administer drugs in-practice.

Customer reviews

Myndshft carries no verified aggregate rating on Capterra or G2. Ask DrFirst for references from practices your size, and confirm payers live in your region.

Who Myndshft is best for

• Infusion suites and IV therapy practices billing insurers
• Practices administering biologics or other in-office injectables
• Weight loss and hormone practices where drug coverage decides the treatment plan

Pricing

Myndshft publishes no pricing. Quotes come through DrFirst, usually depending on transaction volume.

8. Rhyme – best for touchless authorizations at large health systems

Rhyme, formerly PriorAuthNow, puts payers and providers on one network so approvals return untouched. It reports more than 4 million authorizations a year, 300 or more of the largest payers, and 83 of the largest health systems.

The interesting part is gold carding: Rhyme’s data lets a payer and provider agree to drop the authorization requirement for services the provider consistently gets approved, removing the work rather than automating it.

The catch is structural: Rhyme only delivers a touchless decision when the payer has installed it. Check your top five payers against the network before this goes on a shortlist.

Key features

• Touchless authorizations: Processed inside the EHR with no staff intervention
• Gold carding: Tools to drop authorization requirements at the point of care
• Shared dashboard: Payer and provider see the same friction and delay
• All procedure types: Rhyme states 100% procedure-type coverage
• EHR-embedded workflow: Staff stay in the system they already use

Where Rhyme shines

• Eliminating work, not moving it: Gold carding removes authorizations outright.
• Real-time decisions: Where the payer is on the network, the answer returns during the visit.
• Payer relationship: The shared dashboard gives both sides the same evidence.

Where Rhyme falls short

• Dependent on payer adoption: A payer outside the network gives you no benefit at all.
• Enterprise only in practice: The reference customers are the largest health systems in the country.
• No pricing, no reviews: No published price and no verified rating.

Customer reviews

Rhyme carries no verified aggregate rating on Capterra or G2. Named references include Norton Hospital, and it has publicized a partnership with the Ohio Hospital Association.

Who Rhyme is best for

• Health systems and hospital patient access teams
• Provider groups whose volume is concentrated in a few large payers
• Organizations ready to negotiate gold carding with those payers

Pricing

Rhyme publishes no pricing or cost model for either side of the network.

9. Silna Health – best for therapy and behavioral health practices

Silna Health targets a specific version of the problem. In therapy and behavioral health, authorizations cover a block of visits and then expire, so the renewal becomes the workload, not the initial request.

Silna handles the full cycle: tracking authorizations, weekly reminders, submissions, and follow-ups. It reports coverage of more than 1,000 payers across all 50 states, and support for over 250,000 patients.

Named customers include autism and physical therapy providers. If your authorizations are recurring blocks rather than one-off procedures, Silna is built for you.

Key features

• Renewal tracking: Upcoming expiries surfaced with weekly reminders before visits are lost
• Submission and follow-up: Requests sent and chased for the practice
• Wide payer coverage: More than 1,000 payers across all 50 states
• Benefit and cost detail: Patient copay and evaluation cost surfaced with the authorization
• Specialty focus: Workflows for autism, behavioral health, therapy, and allergy practices

Where Silna Health shines

• Recurring authorizations: The renewal calendar is the product; no general tool treats it that way.
• Specialty fit: Autism and therapy authorization rules are specific, and the workflows reflect them.
• Managed model: Submissions and follow-ups leave your front desk entirely.

Where Silna Health falls short

• Narrow scope: Outside therapy and behavioral health, the specialty tuning stops being an advantage.
• Younger company: Less operating history than networks and clearinghouses here.
• No pricing, no reviews: No published cost and no verified rating.

Customer reviews

Silna Health carries no verified aggregate rating on Capterra or G2. Named customers include Behavior One Autism Solutions, Elite Alliance Physical Therapy, and Autism Learning Partners.

Who Silna Health is best for

• Autism and applied behavior analysis providers
• Physical and occupational therapy practices with recurring visit authorizations
• Behavioral health and allergy practices losing visits to expired approvals

Pricing

Silna Health publishes no provider pricing. Sample costs on the site describe patient copays, not what your practice would pay.

Feature comparison: All nine platforms side by side

The table below compares all nine platforms on the five points that decide the purchase. Every entry was checked against the vendor’s own site in August 2026.

Key finding: eight of the nine vendors publish no price for a practice. Pabau is the only one with a figure on its own site. Two are free at the point of use because health plans and pharmacy benefit managers fund the network instead.

The second finding is the last column. Most of these tools finish at the payer’s decision and hand you a number to copy somewhere else. That copy step is where an approved authorization turns into a denied claim.

What the CMS prior authorization rule requires in 2026 and 2027

The CMS Interoperability and Prior Authorization final rule, CMS-0057-F, sets two separate deadlines, and most articles collapse them into one. The operational changes start January 1, 2026. The FHIR Prior Authorization API arrives a year later.

Impacted payers include Medicare Advantage organizations, plus Medicaid and CHIP managed care plans. State Medicaid and CHIP fee-for-service programs are covered too, along with qualified health plan issuers on the federally facilitated exchanges.

• From January 1, 2026: Impacted payers must decide expedited requests within 72 hours and standard requests within seven calendar days. Qualified health plan issuers on the exchanges are excluded from the timeframe requirement.
• From 2026, on every denial: Payers must give a specific reason for a denial, whether the decision arrives by portal, fax, email, mail, or phone.
• By March 31, 2026: Payers must publish their first set of prior authorization metrics on their own websites, annually thereafter.
• From January 1, 2027: Payers must run a FHIR Prior Authorization API. That API lists covered items, identifies documentation requirements, and returns approvals, denials, or requests for more information.

Now the part that changes your shortlist. CMS states plainly that the policies in this final rule do not apply to prior authorization decisions for drugs. Every API requirement and every timeframe carries the same exclusion.

So the rule tightens procedure and service authorizations and leaves prescription authorizations exactly as they are. If most of your authorization work is prescriptions, no deadline in 2026 or 2027 is going to help you. That is an argument for tooling, not patience.

There is also a reporting consequence for clinicians. MIPS eligible clinicians report a new Electronic Prior Authorization measure from the 2027 performance period. The attestation needs one request sent through a Prior Authorization API for a medical item or service. Drugs are excluded there too.

How to choose prior authorization software for your practice

Choose by benefit type first, then by who the vendor sells to, then by where the approval ends up. Feature lists come fourth, because they all read the same. Five checks decide it.

1. Run the PA mix test. Split last month’s authorizations into drug benefit and medical benefit. The bigger half names your category, and roughly half the shortlist disappears.
2. Confirm you are the customer. Cohere Health and Availity AuthAI are sold to health plans. Surescripts reaches you through your EHR vendor. Ask who signs the contract before you book a demo.
3. Check your own payers, not the headline count. “300 or more payers” means nothing if your top three are not on it. Name your five biggest payers and make the vendor confirm each one.
4. Follow the number to the claim. Ask where the authorization code, approved date range, and unit count end up. If the answer is a portal your biller reads from, budget for the retyping. Integration depth decides this, and “integrates” covers both bidirectional sync and a one-way webhook.
5. Price the whole stack, not the module. A free portal plus a separate scheduling, records, and billing system is not cheaper than one platform. Add up what you already pay before you compare.

How Pabau keeps the authorization attached to the appointment and the claim

In practices we onboard, the authorization is rarely what failed. The approval was granted. It then sat in a portal or a spreadsheet while the visit moved, and the claim went out without it.

Pabau closes that loop by holding the insurer, the policy, and the authorization code on the client record itself. When a claim is raised, background validation checks those fields and holds the submit button until the missing detail is filled in.

Claims then route out through Claim.MD in the US, with regional claims and billing connections in the UK and Australia. Insurers outside those connections can be reached by email submission from inside Pabau, so a claim never falls back to paper.

The wider benefit is the ledger. Aesthetic and wellness practices bill some patients through insurers and charge others directly. Pabau keeps both streams, the treatment note, and the invoice on one patient timeline. Every subscription includes all of it.

Keep every authorization attached to the appointment it covers

Pabau stores the insurer, policy, and authorization details on the client record, then validates them before a claim leaves your practice. Book a demo to walk through the claims workflow end to end.

Book a demo

Conclusion

Pick the category before you pick the vendor. Almost every disappointing prior authorization purchase is a drug benefit tool bought for procedure work, or the reverse. No amount of automation fixes a network that cannot see your request.

If prescriptions dominate your week, CoverMyMeds costs nothing and there is little reason to delay. If procedures dominate, start with the free Availity Essentials portal and only pay for automation once you know the volume justifies it.

Either way, the approval has to travel. An authorization code stranded in a portal is a write-off waiting for a remittance. That is a scheduling and billing problem rather than an authorization one. Book a demo to see how Pabau keeps the approval, the appointment, and the claim in one record.

Continue your research

Checking coverage before you request the approval? Insurance eligibility verification explains how to confirm benefits before a patient books a treatment.

Approvals still turning into denials? Denial management in healthcare covers how to work a rejection back into a paid claim.

Frequently asked questions