Humata Health Launches Provisional Affirmations, Which Can Reduce the Prior Authorization Process to Within 3 Minutes

Available to Oklahoma providers participating in WISeR, the new capability streamlines approvals and care delivery by quickly verifying that a prior authorization request meets Medicare's coverage criteria

WINTER PARK, Fla.--(BUSINESS WIRE)--Humata Health, a leader in super intelligence (SI)-powered, touchless prior authorizations, today announced it is issuing provisional affirmations to providers in Oklahoma’s WISeR pilot when its SI confirms that their request fulfills Medicare's medical necessity rules. The company’s core principle — its SI can only say “yes” to a case and cannot issue a denial, routing any case it can't clear on its own to a licensed clinician for review — remains unchanged.

Humata, which was recently acquired by R1, serves as Oklahoma’s technology partner for the WISeR (Wasteful and Inappropriate Service Reduction) model run by the Centers for Medicare & Medicaid Services (CMS). Humata’s SI has been able to make quick affirmative clinical determinations since WISeR began, but until now it notified providers only after CMS's own system had separately processed the request, which could take up to 24 hours.

Providers can now learn that result within three minutes, often well ahead of when CMS finishes its own processing — enabling them to begin the corresponding care almost immediately. In the last 30 days, Humata has provisionally affirmed over 65% of eligible WISeR requests using SI across more than 2,980 cases. (The remaining requests are not necessarily cases where the SI was unable to make an accurate determination; they may have required additional clinical documentation or failed to meet the applicable Medicare NCD or LCD criteria and therefore required human clinical review.) A provisional affirmation covers clinical criteria only, so other payment and coding rules still apply before a claim is processed for payment.

"When a physician seeks prior authorization before moving forward with a scan or procedure, every extra hour that request sits in review means a longer wait for the patient," said Jeremy Friese, MD, Founder and CEO of Humata Health. "We spent months making sure we understood exactly how CMS applies its rules on the back end before implementing provisional affirmation. Our goal is to ensure Oklahoma providers experience the fastest, smoothest and most reliable prior authorization process possible.”

CMS’s system will continue to process each prior authorization request and issue a unique tracking number on its own timeline. But providers who get provisional affirmation no longer have to wait for CMS because Humata can alert them that they can move forward with care. When SI can't affirm in minutes, it is enabling human review efficiently, with an average provisional turnaround time (TAT) of 2 hours, 15 minutes.

Humata has also expanded its gold carding program, which exempts high-performing providers from prior authorization requirements. As of Oct. 1, 29 Oklahoma providers qualified. Humata expects this number to grow as more practices build a track record of accurate, error-free prior authorizations under WISeR.

About Humata Health

Humata Health, which was acquired by healthcare revenue management leader R1 in September 2026, is a leader in AI-powered, touchless prior authorizations. A health tech company “Built for Yes,” its mission is to make prior authorization easy and seamless for providers, payers and the patients they serve. With the industry’s largest ecosystem of integrations and proprietary technology that gathers the right clinical information required for fast approval, the Humata platform is the only truly end-to-end prior authorization solution for all services and procedures.