Introduction
Abridge, the leading enterprise-grade AI Solution platform for clinical conversations, has announced a groundbreaking collaboration with Availity, the nation’s largest real-time health information network. Together, they are launching a first-of-its-kind prior authorization experience that promises to transform how clinicians, health plans, and patients navigate medical necessity reviews.
This innovative engagement leverages cutting-edge artificial intelligence technology grounded in real-time clinician-patient conversations to facilitate a more efficient, streamlined process between healthcare providers and health insurance plans. Rather than creating fragmented, parallel AI systems across different healthcare stakeholders, Abridge and Availity are working collaboratively to ensure that shared clinical context captured at the point of conversation powers critical administrative processes, including prior authorization review and submission. This integrated approach is designed to improve outcomes for patients while supporting the clinical teams delivering their care.
The Partnership Details
This collaboration represents the convergence of two trusted, scaled organizations operating at the forefront of healthcare innovation. The partnership combines complementary strengths to address one of healthcare’s most persistent challenges: the administrative complexity of prior authorization.
Abridge’s Enterprise AI Platform
Abridge brings its enterprise-grade AI platform to the partnership, currently serving over 200 health systems nationwide. The platform is projected to support more than 80 million patient-clinician conversations throughout 2026, demonstrating significant market penetration and trust within the healthcare provider community. Abridge’s proprietary Contextual Reasoning Engine technology enables clinicians to gain real-time visibility into relevant clinical information during patient conversations, supporting documentation that aligns seamlessly with prior authorization requirements.
This technology captures the nuances of clinical dialogue and transforms conversational data into structured, actionable information that can be immediately utilized for administrative purposes without requiring additional manual data entry or documentation effort from already-burdened clinicians.
Availity’s FHIR-Native Technology
Availity contributes its next-generation, FHIR-native Intelligent Utilization Management solution to the collaboration. This advanced technology helps both payers and providers digitize and operationalize coverage requirements directly within existing administrative workflows, eliminating friction and reducing delays.
Availity’s FHIR-native APIs (Fast Healthcare Interoperability Resources) enable fast, scalable, and secure connectivity of payer information across the entire healthcare ecosystem. “At Availity, we’ve invested in building AI-powered, FHIR-native APIs designed to bring clinical policy logic directly into provider workflows,” explained Russ Thomas, CEO of Availity. “By embedding our technology at the point of conversation, we’re enabling faster, more transparent utilization management decisions rooted in clinical context. We’re excited to collaborate with Abridge and to demonstrate what’s possible when payer intelligence meets real-time provider workflows.”
Key Benefits and Features
The development of real-time prior authorization capabilities represents just one component of a broader revenue cycle collaboration focused on applying real-time conversational intelligence across the entire patient, provider, and payer experience ecosystem. The companies are working together on workflow alignment between their respective platforms in several critical areas:
Simplified Prior Authorization
The partnership aims to align utilization management and order submission directly within clinical conversations. The ambitious goal is to enable payer determination during the actual patient visit, eliminating the traditional delay between ordering a service and receiving authorization approval. This real-time approach could fundamentally transform the patient experience by providing immediate clarity on coverage and next steps.
Documentation Gap Visibility
One of the most innovative features is the ability to highlight documentation gaps during the conversation itself—not after the fact. This real-time feedback supports high-quality, compliant, and clinically accurate documentation that accurately represents the patient’s current condition. By addressing documentation deficiencies in the moment, clinicians can avoid the frustration of denied claims or delayed authorizations due to incomplete information.
Authorization Integrity
Supporting more complete and accurate documentation at the point of conversation reduces downstream administrative cycles between payers and providers. This approach keeps the needs of the patient at the center of every authorization request, ensuring that medical necessity is clearly communicated and understood by all stakeholders from the outset.
Reduced Administrative Burden
By supporting clinicians with prior authorization documentation and submission during patient visits, the collaboration aims to help both payers and providers significantly reduce manual workflows, administrative delays, and other time- and resource-intensive requirements, such as peer-to-peer consultations. This efficiency gain translates to more time for direct patient care and reduced operational costs across the healthcare system.
Industry Impact and Future Vision
“Abridge and Availity are each bringing national scale, deep trust, and a track record of solving important challenges across the care and claims experience to this partnership,” said Dr. Shiv Rao, CEO and Co-Founder of Abridge. “We’re building real-time bridges between patients, providers, and payers, unlocking shared understanding, focused at the point of conversation.”
This vision of seamless, real-time integration between clinical conversations and administrative processes represents a paradigm shift in healthcare operations. By eliminating artificial barriers between documentation, authorization, and care delivery, the partnership has the potential to create a more patient-centered, efficient healthcare system that benefits all stakeholders while maintaining the highest standards of clinical quality and regulatory compliance.
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