Humata Health

What Humata Health does

Humata Health is an AI-native healthcare technology company that automates the full prior authorization lifecycle for providers, payers, and pharmacies. Founded in 2023 by Dr. Jeremy Friese, a former Mayo Clinic interventional radiologist and former president of Olive AI, the company sells a SaaS platform branded as Frictionless Prior Authorization and PAthway that performs AI-driven clinical document extraction, payer policy matching, intelligent clinical bundling, automated submission, real-time status tracking, and post-approval monitoring. The platform integrates into Epic and other EHRs, connects directly to payer APIs rather than scraping portals, and is embedded within Microsoft Dragon Copilot for in-workflow access by clinicians.

The company serves large health systems, academic medical centers, multi-specialty provider groups, specialty pharmacies, infusion centers, and payers. Disclosed customers include Texas Health Resources, UHealth, Allegheny Health Network, URMC, Renown Health, Bellin and Gundersen, Southcoast Health, Duly Health and Care, Premier Health, Rochester Regional Health, Lee Health, Hartford HealthCare, Centra Care, and Alignment Health. The business model combines quote-based annual enterprise SaaS subscriptions tailored to health system size and prior authorization volume, transaction-based revenue under the CMS WISeR Model in Oklahoma (where CMS pays a percentage of expenditures from averted wasteful care, running January 2026 to December 2031), and channel-driven revenue through the Optum Digital Auth Complete partnership and Azure Marketplace listing.

Humata's go-to-market blends direct enterprise sales to VP of Revenue Cycle, CFO, and Director of Patient Access buyers at health systems with API-first distribution through EHR integrations, Microsoft Dragon Copilot embedding, and Azure Marketplace. The company is headquartered in Winter Park, Florida with an additional office in Menlo Park, California, operates with 101-250 employees, and has raised $25 million in a June 2024 Series A led by Blue Venture Fund and LRVHealth. The company holds HITRUST CSF v9.5.0 r2 certification, is HIPAA-compliant, and undergoes annual SOC 2 Type II audits.

Name

Humata Health

Legal name

Humata Health, Inc.

Website

https://humatahealth.com

Company type

Private

Founded year

2023

Operating status

Operating

Headcount range

101–250 employees

Short description

Humata Health is an AI-native prior authorization automation platform that serves health systems, payers, and pharmacies. Founded in 2023 by Dr. Jeremy Friese, it automates clinical documentation, policy matching, submission, and status tracking through Epic-integrated software embedded in Microsoft Dragon Copilot.

Ownership category

akta.pro rank

Product category

Healthcare Prior Authorization Software

NAICS

Software Publishers (5132)

SIC

Services-Prepackaged Software (7372)

akta.pro primary industry

Utilization Management & Prior Authorization Analytics (HLACAHAE)

akta.pro secondary industry

Prior Authorization (ePA), Utilization Management & Coverage Verification (HLACAKAE)

Keywords

• Prior authorization automation
• Healthcare AI software
• Clinical workflow automation
• Payer-provider integration
• Revenue cycle management

Headquarters

HQ city

Winter Park

HQ country

United States

HQ region

North America

Offices2 records

Markets served

GTM type

B2B

Offering type

Software

Cost components

Technology or R&D, Personnel, Marketing or Sales, Operations, Infrastructure

Revenue model

1. SaaS Platform Subscription: AI-powered prior authorization platform sold as subscription to healthcare providers and payers. Pricing is quote-based, tailored to health system size and volume.
2. WISeR Model Participant: As a CMS WISeR Model Participant for Oklahoma, Humata processes Medicare prior authorization requests with CMS paying a percentage of expenditures from averted wasteful care.
3. Enterprise Licensing: Large health system deployments with per-implementation and recurring licensing fees. Texas Health Resources, Allegheny Health Network deployments suggest enterprise contracts.

Pricing tiers

Go-to-market motion2 records

Distribution channels4 records

Marketing channels6 records

Core offering

Humata Health sells an AI-driven prior authorization platform (Frictionless Prior Authorization™ / PAthway) that automates the full authorization lifecycle — from point-of-order requirements determination and payer policy sourcing, through AI-driven clinical documentation bundling, submission, real-time status tracking, and post-authorization monitoring. The platform is offered as a SaaS subscription to U.S. health systems, payers, and specialty pharmacies, with dedicated operational support for Oklahoma providers participating in the CMS WISeR Model.

Product overview

Humata Health offers Frictionless Prior Authorization™, a unified AI-driven platform purpose-built specifically for prior authorization. The core platform delivers intelligent automation, AI-driven policy matching, and real-time payer connectivity to simplify and accelerate the authorization lifecycle. Key product components include: PAthway (the main software platform handling the full prior authorization workflow from order through approval and monitoring), the Humata WISeR Portal (Oklahoma-specific portal for CMS WISeR Model participants), and Microsoft Dragon Copilot Integration (embedded prior authorization access within Microsoft Dragon Copilot workflows). The platform serves healthcare providers, pharmacies, and payers across medical services, procedures, and specialty drugs.

Differentiator

Problem solved

Functional benefit

Brands

• PAthway: Humata's prior authorization platform that integrates with payers, supports the full authorization continuum using automation and AI, triggering at point of order.

Products and services

• Frictionless Prior Authorization™ (PAthway) Humata's primary AI-driven prior authorization platform enabling intelligent automation, AI-driven policy matching, and real-time payer connectivity across the full authorization lifecycle from order to outcome. Determines auth requirements at point of order, sources medical necessity policies from payers, generates clinical bundles via NLP, submits requests, provides automated status tracking, and monitors for post-approval changes that could invalidate claims. Supports up to 90% touchless authorizations with human-reviewed cases resolved in under two minutes. Sold to healthcare providers, payers, and pharmacies as a SaaS subscription.
• Humata WISeR Portal Dedicated self-serve portal for Oklahoma providers participating in the CMS WISeR Model pilot. Supports prior authorization submissions, criteria visualization, display of clinical information requirements, and dashboard with PA status and determination letters for Medicare FFS prior authorization requests processed by Humata as the designated WISeR technology vendor for Oklahoma through 2031.

Quantifiable outcome

• 96% first-pass approval rate in recent partnerships
• +6 more outcomes

Named customers14 records

Segments3 records

Ideal customer profiles3 records

Technology focussed Yes

API detail

Has API

No

API docs

API detail

Core technology

AI maturity

App detail

Integration1 record

AI capability6 records

Feature10 records

Partnerships

Six partnerships are on record, tiered supporting, core and flagship.

• AccuKnoxsupportingTechnology or Integration · 13 March 2026Zero Trust CNAPP security partnership to enhance SaaS platform security and meet HIPAA compliance requirements through Application Security Posture Management (ASPM) with DAST scanning, automated compliance, and CI/CD integration with Azure DevOps and GitLab.
• OptumcoreStrategic or Co-development Partner · 19 February 2026Partnership to embed real-time approvals and AI-driven automation into clinical workflows through Optum Digital Auth Complete powered by Humata. Optum serves 129 million consumers and works with over 90,000 physicians.
• CMS (Centers for Medicare & Medicaid Services)flagshipStrategic or Co-development Partner · 7 November 2025Selected as WISeR Model Participant for Oklahoma in CMS's $0.5B initiative using AI and machine learning for prior authorization in Medicare FFS. WISeR model runs January 2026 - December 2031 in six states. Humata processes all WISeR prior authorization requests for Oklahoma providers.
• Microsoft Dragon CopilotcoreTechnology or Integration · 17 October 2025Humata's AI-driven prior authorization technology integrated into Microsoft Dragon Copilot AI clinical assistant, enabling clinicians to access prior authorization tools within their regular workflow. Integration announced October 2025 with over 100,000 Dragon Copilot users.
• Allegheny Health NetworkcoreTechnology or Integration · 28 April 2025First touchless prior authorization from order to approval partnership. Humata automated and centralized 200,000+ annual prior authorizations across AHN's 14-hospital system.
• EpiccoreTechnology or Integration · 30 June 2024EHR integration partnership. Humata's platform integrates with Epic through payer connectivity and clinical data extraction capabilities.

Scale indicators11 records

Recent moves6 records

Expansion highlights6 records

Direct peers

• Cohere Health: Direct competitor offering AI-driven prior authorization and utilization management for health plans and providers. Cohere's specialty-focused PA platform (notably in cardiology, oncology, orthopedics, and radiology) competes head-to-head with Humata's PAthway platform across the same payer/provider buyer base.
• Myndshft: Prior authorization automation platform that uses AI/NLP to determine authorization requirements and assemble clinical documentation for submission to payers. Directly comparable product functionality targeting the same providers and payers as Humata.
• Xsolis: AI-driven utilization management and prior authorization platform focused on payer-provider collaboration, particularly for inpatient reviews and DRG-level decisions. Overlaps with Humata in UM/PA analytics and serves many of the same health system customers.
• Infinx: Prior authorization and revenue cycle automation company serving hospitals, imaging centers, and specialty practices. Competes directly with Humata in PA workflow automation, particularly for imaging, cardiology, and specialty drug authorizations.

Emerging players

• Anterior: Earlier-stage AI company applying LLMs to prior authorization and clinical documentation workflows for payers and providers. Addresses the same pain point as Humata with overlapping buyer personas but at an earlier commercial stage.
• Innovaccer: Healthcare data and analytics platform with growing provider/payer workflow automation capabilities, including adjacent utilization management and care coordination use cases that intersect with Humata's AI-driven PA offering.

Broad incumbents

• Availity: Large, established healthcare information network used by payers and providers for eligibility, claims, and prior authorization transactions. Competes with Humata at the connectivity/workflow layer, but its broader portfolio dilutes specialization in AI-driven PA automation.
• Optum (UnitedHealth Group) / Change Healthcare: Optum is simultaneously Humata's largest partner (Digital Auth Complete) and most powerful potential competitor via its embedded PA, utilization management, and InterQual/Celsius solutions inside the UnitedHealth payer-provider stack.
• Edifecs: Healthcare data interoperability and prior authorization solution provider with deep payer-side deployment. Competes in PA workflow automation and policy management, particularly with payer customers, though with a broader EDI/payment-integrity focus.
• Waystar: Large healthcare revenue cycle management platform serving hospitals and health systems. Includes prior authorization as part of its broader RCM suite, competing with Humata at the provider-buyer level for budget allocation within revenue cycle.

Market position

Strengths5 records

Weaknesses5 records

Competitive moat5 records

Key risks6 records

Key highlights7 records

Customer concentration

• LinkedInlinkedin.com/company/humatahealth

Compliance3 records

Revenue estimate

Valuation estimate

Number of profiles

Profiles2 records

Funding overview

Funding rounds1 record

Investors6 records

Funding detail is available on the Subscription and Enterprise plan.Contact sales →

M&A

Investments

M&A and investment is available on the Subscription and Enterprise plan.Contact sales →

Frequently asked questions about Humata Health