10 questions to ask your EHR vendor about electronic prior authorization before Jan. 1

Humana and athenahealth have expanded their electronic prior authorization partnership across athenahealth's network of more than 180,000 physicians and clinicians, Fierce Healthcare reported. In September alone, more than 6,000 providers sent nearly 35,000 electronic prior authorizations to Humana through athenaOne, and more than 70 percent went through without staff supplying more information, the companies said.

For practices on other systems, that is a preview, not a promise. Under the CMS Interoperability and Prior Authorization final rule, Medicare Advantage plans, Medicaid and CHIP programs and marketplace plans on the federal exchange must generally have prior authorization APIs running by Jan. 1, 2027. The rule regulates payers, not practices, and a payer API does nothing for a practice whose EHR can't connect to it. Meanwhile, the AMA's 2025 Prior Authorization Physician Survey found practices complete 40 prior authorizations per physician each week and spend 13 hours of physician and staff time on them.

That puts the next move on your EHR vendor, and the conversation needs to happen before the calendar flips, not after a first quarter of faxes. Our prior authorization handbook covers the rule in depth. Here are 10 questions to put to your vendor now.