Smart Health Network PBC
Smart Health Network provides shared infrastructure that streamlines prior-authorization workflows by connecting health plans, providers, and patients within their existing systems. The platform offers real-time request tracking with status updates, reducing phone calls and administrative delays. Testing is currently open using synthetic data, with limited production for medical prior-authorization workflows beginning December 1.
- Healthcare Technology
- Digital Health
- Software Only
Funding
Founders
Founder details are not available yet.
Product
Problem
Prior authorization in healthcare often involves repeated phone calls, missing documents, and patients left waiting for care decisions. Providers and health plans can each have modern software yet still depend on manual handoffs, separate portals, and duplicated paperwork to complete a single request, creating administrative waste and delays in care.
Solution
Smart Health Network provides a common, shared network that connects health plans, providers, and patients so prior-authorization requests, information, and answers can move across the systems they already use. The platform tracks each request in real time, showing status updates such as receipt confirmation, missing information, and next required actions, reducing the need for phone calls and manual coordination. Organizations can reuse connections, trusted identity information, and common rules instead of rebuilding separate arrangements for each payer-provider relationship. The network is designed as neutral, shared infrastructure that can extend beyond prior authorization to other healthcare transactions like referrals and clinical information exchange.
Target Audience
Primary users are health plans, healthcare providers, hospitals, health information exchanges, and state Medicaid programs seeking to streamline prior-authorization workflows and reduce administrative burden.
Features
- Real-time request tracking with status updates including delivery confirmation, plan receipt, and decision reporting
- Shared network model (N×1) that replaces separate point-to-point connections (N×N) between payers and providers
- Synthetic-data testing environment available before production agreements are in place
- Reusable connections, credentials, and configuration across multiple payer-provider relationships
- Neutral public-benefit utility structure with independent Governance Council and Data Rights Trust
- No fees to join, connect, or use designated Open Access transactions