Humata Health
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.
- Company typePrivate
- Founded2023
- HeadquartersWinter Park, United States
- Headcount101–250
- GTM typeB2B
- OfferingSoftware
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.
Humata Health firmographics
Firmographics- 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
Humata Health industry classification
Industry- 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
Where Humata Health is headquartered
LocationHeadquarters
- HQ city
- Winter Park
- HQ country
- United States
- HQ region
- North America
Offices2 records
Markets served
Humata Health business model
Business model- GTM type
- B2B
- Offering type
- Software
- Cost components
- Technology or R&D, Personnel, Marketing or Sales, Operations, Infrastructure
Revenue model
- 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.
- 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.
- 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
| Model | Billing | Price |
|---|---|---|
| Subscription | Annual | Enterprise health system tier for large hospital networks |
| Subscription | Annual | Mid-market provider tier for smaller health systems |
| Subscription | Annual | Payer solution tier for health insurance companies |
Go-to-market motion2 records
Distribution channels4 records
Marketing channels6 records
Humata Health product offering
Product offeringCore 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
Companies that use Humata Health
Customer profileNamed customers14 records
Segments3 records
Ideal customer profiles3 records
Humata Health technology and API
TechnologyTechnology focussed Yes
API detail
- Has API
- No
- API docs
- API detail
Core technology
AI maturity
App detail
Integration1 record
AI capability6 records
Feature10 records
Humata Health partnerships and signals
Strategic signalPartnerships
Six partnerships are on record, tiered supporting, core and flagship.
- AccuKnoxsupportingZero 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.
- OptumcorePartnership 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)flagshipSelected 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 CopilotcoreHumata'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 NetworkcoreFirst touchless prior authorization from order to approval partnership. Humata automated and centralized 200,000+ annual prior authorizations across AHN's 14-hospital system.
- EpiccoreEHR 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
Humata Health competitors and assessment
Company assessmentDirect 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
Humata Health social profiles
Digital presenceHumata Health compliance and trust
Trust signalCompliance3 records
Humata Health financial estimates
Financial estimateRevenue estimate
Valuation estimate
Humata Health leadership team
Management profileNumber of profiles
Profiles2 records
Humata Health funding detail
Funding detailFunding overview
Funding rounds1 record
Investors6 records
Funding detail is available on the Subscription and Enterprise plan.Contact sales →
Humata Health M&A and investment
M&A and investmentM&A
Investments
M&A and investment is available on the Subscription and Enterprise plan.Contact sales →
Frequently asked questions about Humata Health
What does Humata Health do?
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.
Is Humata Health a public or private company?
Humata Health is a private company. It is classified as venture growth investor backed and is currently operating.
When was Humata Health founded?
Humata Health was founded in 2023. It employs 101 to 250 people.
Where is Humata Health based?
Humata Health is headquartered in Winter Park, United States, in the North America region.
How does Humata Health make money?
Three revenue lines are on record. SaaS Platform Subscription is the primary driver. The others are WISeR Model Participant and enterprise Licensing.
Who are Humata Health's main competitors?
Direct peers on record are Cohere Health, Myndshft, Xsolis and Infinx. Emerging players are Anterior and Innovaccer. Broad incumbents are Availity, Optum (UnitedHealth Group) / Change Healthcare, Edifecs and Waystar.
Does Humata Health have an API?
No public API is recorded for Humata Health.
What industry is Humata Health in?
Humata Health's product category is Healthcare Prior Authorization Software. Its primary akta.pro industry code is HLACAHAE, Utilization Management & Prior Authorization Analytics, with a secondary code of HLACAKAE, Prior Authorization (ePA), Utilization Management & Coverage Verification. Its NAICS code is 5132 and its SIC code is 7372.