Prior authorization & UM · Touchless prior auth network
Rhyme
Rhyme (formerly PriorAuthNow) is a provider-payer prior authorization network that aims for touchless submission and status, with observation analytics and gold-carding tools. It is not a specialty-only PA portal for a single drug class.
Strong fit
- Large provider organizations and health systems already living inside high prior-auth volume with payer partners on the network
- Teams that want touchless submission and status across many payers, including beyond a single specialty portal
- Buyers evaluating gold-carding and observation analytics with participating plans
Weak fit
- Small clinics that need a lightweight specialty PA tool without network onboarding
- Organizations whose payers are not on Rhyme's connected network
- Buyers seeking an enterprise UM policy engine for medical directors
Bottom line
Rhyme (formerly PriorAuthNow) earns a Conditional for providers whose prior auth pain is network connectivity and touchless processing across many payers. Marketing cites millions of authorizations per year and broad payer coverage. Outcomes depend heavily on whether your priority payers and EHR workflows are already connected. Public revenue estimates are mid-market but thin and inconsistent, so diligence should demand current volume and payer maps for your mix. Pricing is quote-based. Score sits below Infinitus and SamaCare because fit is network-dependent and packaging is less clear for mid-market specialty clinics.
Score breakdown
Weights: Outcomes 35% · Product 30% · Implementation 20% · Pricing clarity 15%.
Rhyme automates prior authorization submission, tracking, and observation across a provider-payer network, with gold-carding tools aimed at removing unnecessary auth over time.
It is not a specialty-only portal and not a payer UM policy engine. Value concentrates where your payers and EHR are already on the network.
Score reflects Conditional fit until connectivity for your payer mix is proven in diligence.
Competitor landscape
| Vendor | Overall | Ease of implementation |
|---|---|---|
| Rhyme | 6.5 | 6.3 |
| Infinitus | 7.7 | 7.4 |
| SamaCare | 7.1 | 7.0 |
| Develop Health | 7.0 | 6.8 |
| Valer | 6.6 | 6.4 |
Pricing
| Item | Detail |
|---|---|
| Model | EHR-integrated prior authorization network connecting providers and payers; quote-based. |
| What usually drives cost | Authorization volume, payer connectivity footprint, and EHR integration scope. |
| What to ask in diligence | Per-auth or platform fees for your top payers, with a written map of which payers are truly touchless today. |
| Published pricing | Public list price: not published. |
Prerequisites for purchase
| Need | Why it matters |
|---|---|
| What you need to get Rhyme to function | |
| Written map of priority payers and auth volume | Network value is payer-specific. |
| EHR integration owner for submission and status | Portal hopping is what you are trying to leave. |
| Access operations staff for exceptions | Touchless is never 100%. |
| Security and BAA path for payer connectivity | Network onboarding stalls on paperwork. |
| Baseline auth cycle time by payer | Without a baseline, gold-carding claims are slides. |
| What will maximize your value | |
| Confirm which payers are truly touchless for your mix | Marketing coverage is not your coverage. |
| Measure cycle time and touch rate by payer | Average network stats hide local gaps. |
| Pilot one service line before enterprise rollout | Big-bang hides connectivity holes. |
| Train staff on observation dashboards | Unused analytics do not remove auth. |
| Align with payer partners on gold-carding criteria | Unilateral hope is not a program. |
| Deal-breakers | |
| Your top payers are not on the network. | |
| You need a specialty-only lightweight portal. | |
| No EHR integration bandwidth exists. | |
| You will not staff exceptions. | |
| Leadership expects all prior auth to disappear in month one. | |
Value creation time frame
| # | Stage | Typical range |
|---|---|---|
| 1 | Contract signed → kickoff | 2-6 weeks (security review, EHR scoping, payer or drug mix mapping) |
| 2 | Kickoff → first live workflow | 4-12 weeks for first specialty or site |
| 3 | First live workflow → steady value | 2-5 months before exception queues stabilize |
Methodology
| Weight | Factor | What it measures |
|---|---|---|
| 35% | Customer outcomes | Whether buyers get measurable operational or clinical-workflow results after go-live |
| 30% | Product | Capability depth, reliability, and fit for the job the category actually buys |
| 20% | Implementation | How hard it is to stand up, integrate, train, and stabilize |
| 15% | Pricing clarity | Whether a buyer can model total cost without a mystery quote |
| Label | Meaning |
|---|---|
| Highly recommend | Strong outcomes and product with manageable caveats |
| Recommend | Solid fit for the right buyer; know the tradeoffs |
| Conditional | Only with a specific use case or heavy caveats |
| Not recommended | Avoid for most buyers in this category |
Read our full methodology for how we weight scores and assign recommend labels.