Humata Health

AI prior authorization for providers and payers

Our take

Humata Health builds AI software that automates prior authorization for hospitals, health systems, and medical groups, with a product that also serves payers. Founded in 2023 by Jeremy Friese, MD, a former Mayo Clinic interventional radiologist who previously founded Verata Health (acquired by Olive AI in 2020), the company covers the full auth lifecycle: determining whether an authorization is needed, assembling the right clinical documentation, submitting to the payer, and monitoring status through decision. The pitch is exception-based work, where staff only touch the cases the AI cannot complete.

Humata raised a $25 million round in June 2024 led by Blue Venture Fund and LRVHealth, with Optum Ventures, .406 Ventures, Highmark Ventures, and VentureforGood participating, an investor list weighted toward payers that signals two-sided ambitions. It reports deployments across roughly 225 hospitals and 42,000 physicians, with named customers including Texas Health Resources (which paired Humata with Epic to cover high-volume service lines), Hartford HealthCare, and Renown Health. In 2025 and 2026 it deepened its government footprint, becoming a CMS technology partner for the WISeR model and joining the CMS Electronic Prior Authorization Acceleration initiative, and it extended the product to independent practices that lack EHR integration resources.

What it does

Matches payer policies to determine if prior auth is required
Auto-gathers and bundles clinical documentation for submission
Submits authorizations touchlessly across payer connections
Monitors auth status and flags changes after submission
Detects CPT mismatches before submission
Supports gold-carding and exception-based review workflows

Where it's strong

Founder Jeremy Friese, MD previously built and sold Verata Health, so this is a second product in the same category, not a first attempt.
Strategic investors on the payer side (Blue Venture Fund, Optum Ventures, Highmark Ventures) give it unusual payer connectivity for a provider-facing tool.
Real deployment scale for its age: roughly 225 hospitals and 42,000 physicians, plus CMS selecting it as a technology partner for the WISeR model.

What buyers should weigh

Headline metrics like 96% first-pass approval and 45% fewer manual touches are vendor-reported, so validate them against your own service lines in a pilot.
Its role as an AI clinical-review partner in the CMS WISeR model puts it on both the provider and payer sides of prior auth, which some provider organizations may see as a conflict.
The company traces back to prior authorization assets from Olive AI, which shut down, so diligence which parts of the platform are new versus inherited.

Latest

CMS named Humata a technology partner for the WISeR model (live January 2026) and the company joined the CMS Electronic Prior Authorization Acceleration initiative in June 2026, alongside a new offering for independent practices that requires no EHR integration.