A physician-turned-founder's take on making prior auth actually work | Jeremy Friese (Humata Health)

Jeremy Friese spent a decade as a physician at Mayo Clinic navigating prior auth from the provider side. Now he runs Humata Health, which helps large health systems submit better prior auths to every plan in the country. Humata is a participant in CMMI's WISeR program, handling Oklahoma's fee-for-service Medicare prior auth, and six months in, providers are submitting almost exclusively through Humata's portal. Jeremy's view on fixing prior auth: use AI only to say yes, build real transparency into the rules, and let humans sort out the small fraction that actually requires a fight.

Links referenced

• CBS article on WISeR rollout in Oklahoma: https://www.cbsnews.com/news/medicare-ai-program-wiser-prior-authorization-errors-delays/
• Substack on AI usage in prior auth: https://spinalcolumn.substack.com/p/the-algorithm-is-denying-your-auth
• Humata Health: humatahealth.com
• Jeremy Friese: jeremy@humatahealth.com

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