niche · 4.0 capabilitymarket schemaindustry

Prior Authorization

Score 19.7 / 100 36 providers 14 APIs Search apis.io →

Providers using this tag (36)

Ranked by API Evangelist rating — Exemplar and Strong are expanded by default.

Exemplar 2 Complete, well-documented, and agent-ready
1upHealthHealthcareUnited StatesFHIRHL710 APIs76.0AvailityHealthcareClearinghouseHIPAAX12 EDI4 APIs74.0
Strong 4 Solid coverage with minor gaps
Candid HealthMedical BillingRevenue Cycle ManagementHealthcareClaims1 API65.6DoseSpote-PrescribingeRxHealthcareEHR3 APIs63.2OptumCompanyHealthcareHealth InsuranceClaims113 APIs62.6TruepillPharmacyHealthcarePrescription FulfillmentTelehealth1 API60.3
Developing 5 Usable, with meaningful gaps to close
SilnaCompanyAutomationHealthcare1 API54.0WaystarHealthcareRevenue Cycle ManagementRCMClearinghouse7 APIs46.2Develop HealthCompanyHealthcareBenefit Verification1 API44.6Element5CompanyHealthcareRevenue Cycle ManagementPost-Acute Care1 API44.0SurescriptsHealthcareE-PrescribingHealth Information NetworkNCPDP SCRIPT8 APIs41.1
Thin 5 Limited public surface area
InfinitusCompanyArtificial IntelligenceHealthcareVoice AI1 API35.1UnitedHealthcareHealth InsuranceHealthcareFHIRClaims2 APIs33.2Cohere HealthHealthcareUnited StatesUtilization Management3 APIs33.0Change HealthcareHealthcareTechnologyAnalyticsEDI1 API30.2GenHealth.aiCompanyHealthHealthcareArtificial Intelligence28.2
Emerging 15 Early or largely undocumented
Beacon HealthCompanyHealthcarePrimary CareValue-Based Care23.1InsurfCompanyHealthcareHealth Insurance22.8NotableCompanyApplicationHealthcareArtificial Intelligence21.2LatentCompanyHealthcareHealth SystemsPharmacy18.4ForusCompanyHealthcareHealth IT18.2House RxCompanyHealthcareSpecialty PharmacyPharmacy16.9Parachute HealthCompanyHealthcareDMEePrescribing16.9Latent HealthCompanyHealthHealthcarePharmacy15.3TennrCompanyHealthcareArtificial IntelligenceMachine-Learning13.1MedmonkCompanyHealthcarePharma Market AccessFHIR12.6Forus (fka Tandem Health)CompanyHealthcareMedication Access12.4PlenfulCompanyHealthcarePharmacyArtificial Intelligence12.1Ruma CareCompanyHealthcareHealth Insurance11.7Smile Digital HealthHealthcareFHIRHL7Clinical Data Repository11 APIs11.5Standard PracticeCompanyVoice AIHealthcareRevenue Cycle Management11.3
Minimal 5 Almost no public developer surface
Olive AIHealthcareHealthcare AutomationRevenue Cycle Management7.0Rhyme (fka PriorAuthNow)CompanyHealthcareHealth IT6.2Bookend AICompanyHealthcareRevenue Cycle Management4.7ClaimglideCompanyHealthcareDigital Health3.2Verata HealthCompanyHealthcareArtificial Intelligence2.2

APIs with this tag (11)

Ranked by the provider's API Evangelist rating — the Kin Score is scored per provider, not per API, so every API of a provider shares its band. How the rating works →

Exemplar 1 Complete, well-documented, and agent-ready
1up Electronic Prior Authorization APICMS-0057-F Electronic Prior Authorization solution automating prior authorization submission and decisionin...76.0
Strong 1 Solid coverage with minor gaps
Optum Real (Medical) APIOptum Real point-of-care APIs on the oihub gateway: pre-service eligibility, claim pre-check, claim actions...62.6
Developing 2 Usable, with meaningful gaps to close
Waystar Authorization & Referral APIAutomates prior authorization and referral determination and status, modeled on the X12 278 health care ser...46.2Surescripts Electronic Prior AuthorizationAutomates electronic prior authorization (ePA) between prescribers and PBMs/payers using the NCPDP SCRIPT e...41.1
Thin 6 Limited public surface area
Infinitus Platform APIThe customer-gated Infinitus backend API. Infinitus' own AI Agent Security Guide instructs customers to all...35.1UnitedHealthcare Prior Authorization APIPrior authorization and referral actions33.2Cohere Health Coverage Requirements Discovery (CRD) APIHL7 Da Vinci Coverage Requirements Discovery (CRD) FHIR API that lets a provider system instantly verify wh...33.0Cohere Health Documentation Templates and Rules (DTR) APIHL7 Da Vinci Documentation Templates and Rules (DTR) FHIR API that intelligently gathers and submits the do...33.0Cohere Health Prior Authorization Support (PAS) APIHL7 Da Vinci Prior Authorization Support (PAS) FHIR API that submits an authorization request and returns t...33.0Change Healthcare Medical Network APIJSON-over-REST front end to the HIPAA X12 EDI transaction set — 270/271 eligibility, 276/277 claim status, ...30.2
Emerging 1 Early or largely undocumented
Smile CDR CMS Interoperability SuitePre-packaged CMS-compliant FHIR APIs for US payers — Patient Access, Provider Directory, Drug Formulary, Pa...11.5

Score breakdown

Frequency
46.0
log-scaled weighted occurrences
Breadth
1.0
spread across providers
Quality lift
35.1
mean composite of providers using it
Cohesion
6.4
strength of nearest seed neighbor

Related tags

Clearinghouse 5 co-occurrences Eligibility 10 co-occurrences Revenue Cycle Management 11 co-occurrences Revenue Cycle 5 co-occurrences Patient Access 7 co-occurrences Pharmacy 9 co-occurrences FHIR 10 co-occurrences Health IT 5 co-occurrences

Where this tag comes from

Api tag14
Provider tag33
Openapi tag1
Openapi op tag1

Cohort brief

Auto-generated

The 36 providers in the APIs.io catalog tagged Prior Authorization, scored on the Kin Score. Every figure below is computed from the catalog — nothing here is written.

Providers
36
all scored
Mean Kin Score
29.2
+8.5 vs catalog 20.7
Mean Agent Readiness
11.5
+1.8 vs catalog 9.7
Spread
2.2–76
median 20 · σ 21.8
How the 36 split by band
Exemplar 2Strong 5Developing 4Thin 4Emerging 15Minimal 6
Facet averages, against the whole catalog
FacetThis cohortCatalogDifferenceScored
Access Clarity 35.2 22.3 +12.9 36
Contract Governance 14.8 6.4 +8.4 36
Developer Ergonomics 25.9 17.9 +8 36
Operational Transparency 18.3 11.3 +7 36
Discoverability 63.5 60.4 +3.1 36
Contract Quality 17.4 17.5 -0.1 36

A facet is averaged over the members that carry it, not over the whole cohort — the “Scored” column is that count. Averaging an absent facet as zero would score our own coverage gaps as the providers’ posture.

What this cohort publishes
ArtifactThis cohortCatalogDifference
MCP server (any) 22% 16% +6
MCP server (first-party) 8% 7% +1
Agent Skills 0% 0% 0
OAuth scopes 14% 9% +5
Security 97% 88% +9
Arazzo workflows 6% 2% +4
Governance rules 8% 13% -5

mcp_pct counts any mcp/ artifact including ones API Evangelist derived from the provider OpenAPI; mcp_first_party_pct counts only servers the provider publishes. Prefer the latter.

Top by Kin Score
  1. 1 1upHealth 76
  2. 2 Availity 75.4
  3. 3 DoseSpot 65.5
  4. 4 Candid Health 64.7
  5. 5 Optum 63.4
  6. 6 Truepill 61.9
  7. 7 Silna 55.7
  8. 8 Element5 47.2
  9. 9 Waystar 46.2
  10. 10 Develop Health 45.1
Top by Agent Readiness
  1. 1 Optum 42.6
  2. 2 Candid Health 39.6
  3. 3 Silna 36.2
  4. 4 Develop Health 35
  5. 5 Truepill 35
  6. 6 Availity 31.5
  7. 7 Element5 30.8
  8. 8 DoseSpot 29.6
  9. 9 1upHealth 29.3
  10. 10 Infinitus 20.4
All 36 members of this roster resolve to a scored provider in the catalog.Generated from the catalog build of 25 August 2026, across 26891 providers, using the same computation served by the APIs.io cohort API. Briefs are published for rosters of 5 or more scored providers; below that a distribution is not meaningful.

Work with this as data

Every tag here is available over the APIs.io API and to AI agents over MCP.

MCP server

One button, every client — Claude, Cursor, VS Code and the rest.

https://apis.io/mcp

Tools for tags

7 MCP tools reach this
  • find_tagsBrowse and filter every tag in the catalog.
  • get_cohortThis tag as a scored cohort — every provider carrying it, with scores.
  • cohort_statsPRO — the distribution across this tag: mean, median, band split, adoption rates.
  • cohort_rankingsPRO — the leaderboard, on composite AND agent-readiness axes.
  • apis_io_searchSTART HERE — APIs, providers and tags for one query, each with its total.
  • resolveTurn a domain, URL or GitHub org into the provider it belongs to.
  • find_cohortsEvery scored population of providers in the catalog.
All 92 tools →

Call it yourself

curl for this page
This tag 
curl "https://apis.io/api/v1/tags/prior-authorization"
All tags 
curl "https://apis.io/api/v1/tags?limit=25"
As a scored cohort 
curl "https://apis.io/api/v1/cohorts/tag/prior-authorization"
The distribution (Pro) 
curl "https://apis.io/api/v1/cohorts/tag/prior-authorization/stats" \
  -H "X-API-Key: $APIS_IO_KEY"

Discovery needs no key. Ratings and market analysis are Pro.

Get an API key

Free tier, no email required.

GitHub Google LinkedIn

A second provider on the same verified email joins the account you already have.