Digital prior authorization company PriorAuthNow announced a $25 million funding round led by Insight Partners. The Columbus, Ohio-based company now boasts of $57 million in total venture funding. 

WHAT IT DOES 

PriorAuthNow is focused on prior authorization, which is the process when a medical provider requests approval from a patient's insurer before delivering treatment for a service. The startup is focused on streamlining this process by better connecting healthcare clinicians and payers.

The company does this through its platform, which integrates EHRs and Payer Case Management systems so providers and insurers to collaborate on patient care. 

The tool lets stakeholders share data in one location. The company pitches its tools as an alternative to the status quo, which often involves phone calls and multiple forms, and says it could help its payer and provider clients save time. 

WHAT IT'S FOR 

This new infusion of cash is expected to help the company grow its client base and build out its team. 

“We launched PriorAuthNow to reconstruct this process and create a system that generates significant value for both payers and providers alike," Joe Anstine, CEO and cofounder of PriorAuthNow, said in a statement.

"We’re taking on the arduous challenge of creating an intermediary between these parties by establishing connections with both sides of the system. Through these more meaningful interactions, we are ultimately helping patients achieve a higher level of care, which has been our driving mission. This latest funding round will help fuel this focus.”

MARKET SNAPSHOT 

Digitalizing prior authorization has been shown to save time. According to findings from America's Health Insurance Plans (AHIP), prior authorization requests submitted electronically have a turnaround time that is three times faster than those submitted manually. 

PriorAuthNow isn't the only digital health company focused on boosting payer and provider communication. Cohere Health developed a platform that streamlines the prior authorization process for insurers by providing analytics to identify the best-performing doctors and care paths. In 2021, Cohere Health scored $36 million in Series B funding.