Humata Health vs Silna Health (2026)

Native EHR integration covers order, appointment and clinical document integration, with write backs to the EHR, and Epic is named at Texas Health Resources. Submissions run through 250+ payer connections with direct submission, eFax and a portal assistant. HL7 and FHIR connect to payer UM systems, and Humata also offers an eMPA widget and Power BI analytics.

Sourcehumatahealth.com/technologyread 2026-09-29

Silna works with more than 1,000 payers across 50 states, calling insurers for benefits and authorization status and submitting through their portals. On the provider side it connects to the EHR and practice management systems ABA providers already use, CentralReach and Catalyst among them, so insurance work runs alongside the clinic's existing setup. The list of practice systems is short and centered on ABA platforms, and whether authorization results flow back into them is unclear.

SourceSilna Health, silnahealth.com, /aba-therapy, engineering.silnahealth.com/posts/autonomous-browser-agents-enterprise and /posts/building-phone-agents-healthcareread 2026-10-09

The prior authorization lifecycle runs in stages with conditions. Auth requirements checks automatically close the 20 to 40 percent of cases that need no authorization, and requests route to the medical or pharmacy benefit path. Clinical bundles are matched to policy, and submissions go by direct submit, eFax or portal. Exceptions surface for human review while routine cases stay touchless.

Sourcehumatahealth.com/use-cases/proceduresread 2026-09-29

The prior authorization lifecycle runs from expiration tracking and weekly reminders through form generation, submission and continual payer follow up. It branches as requests for additional information or resubmission raise alerts, denials move to appeal and Medicaid plan switches are flagged so authorizations can be resubmitted to the new plan. For ABA the same lifecycle covers initial assessments, concurrent reviews and reauthorizations. Behind it, document validation rules combine with AND and OR logic into configurations, and a graph decides which rules apply to each document type.

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Orders and appointments in the EHR start each case through the integration, so staff do not open cases by hand. Automated statusing checks internal and external authorizations, and post-auth monitoring watches for payer changes and requests.

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Work starts without staff: weekly expiration reminders, recurring eligibility and benefit checks, real time monitoring of every active patient's coverage, automatic detection of new insurance and Medicaid plan switches, and phone agents that call payers to check whether a submitted authorization was approved. For ABA, authorized hours remaining and upcoming reauthorization deadlines are tracked continuously so renewals go out before therapy is interrupted.

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Policy Translation retrieves, structures and maintains payers' medical necessity policies, which are specific to each plan and specialty and are retrieved through an API. PolicyMatch uses NLP to align the chart's documentation types to those rules before submission. For payers, medical and pharmacy guidelines are digitized into executable logic.

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Silna maintains an always current database of each payer's prior authorization requirements per specialty, kept by its Payor Intelligence team from payer bulletins and the thousands of authorizations it processes each week, and applies it to form generation and document validation so providers never track the rules themselves. Predictive Document Intelligence reads diagnosis reports, treatment plans and progress notes with multimodal models and checks them against those criteria before submission, ABA treatment plans and progress reports included, and Silna reports a 98 percent first pass acceptance rate for requests it validates.

SourceSilna Health, silnahealth.com/prior-authorization, /aba-therapy, /resources/best-prior-authorization-software and engineering.silnahealth.com/posts/document-validationread 2026-10-09

Clinical bundles are built from historical submissions, and their weights adjust to user behavior. Humata names no memory that its agents keep, and no scope or lifetime for one.

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What persists sits on Silna's side: the payer requirements database and the growing record of reviewer corrections that shapes later submissions. The agents work from those shared stores and each authorization's own record, with no memory of a clinic or patient that has its own scope or lifetime.

SourceSilna Health, silnahealth.com and engineering.silnahealth.com/posts/beyond-the-agentread 2026-10-06

Exception based workflows surface only what requires human review. Humata aims for 90 percent touchless authorizations and under two minutes for those a person touches. Staff review the initial clinical bundles while their weights are tuned. Routine cases submit without an approval step.

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Staff stay in the loop where judgment matters. When document validation finds a gap against the payer's criteria, the provider reviews it and decides whether to update the documents or submit as they are, and requests for more information, resubmissions and appeals come back to the team as alerts. Behind the agents, Silna sends a set share of submissions to its own QA reviewers, who can override and correct the agent's work. Routine requests go out without staff touching each one, so there is no clinic sign off before a standard submission reaches the payer.

SourceSilna Health, silnahealth.com/prior-authorization, /resources/best-prior-authorization-software, engineering.silnahealth.com/posts/document-validation and /posts/beyond-the-agentread 2026-10-09

HITRUST CSF v11.5.1 r2 certification covers Humata's services, products and infrastructure. Humata has annual SOC 2 Type II audits, with the report available on request, and is HIPAA compliant. It names no SSO, roles or permission model for the customer's own users.

Sourcehumatahealth.com/security-and-complianceread 2026-09-29

Security starts with SOC 2 Type II certification through Vanta, operation under HIPAA and a pledge to treat patient confidentiality as a priority. On the agent side, each browser session is tied to a single provider through row level security, so one clinic's agent cannot reach another clinic's records. There is no single sign on or role management for a clinic's own staff.

SourceSilna Health, silnahealth.com and engineering.silnahealth.com/posts/autonomous-browser-agents-enterpriseread 2026-10-06

An Analytics and Audit Trail component sits in every authorization lifecycle, with customizable Power BI dashboards across staff, payers and service lines. On the payer side, reviews run as structured, auditable processes for CMS-0057. Humata does not say what the audit trail records.

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Clinics follow each authorization from submission to approval on a dashboard, with approvals passed along as they arrive. Inside Silna, every inference call and tool execution of a browser agent is saved as a pipeline step and each session gets a quality score from 0 to 100, a record that serves Silna's own engineers and reviewers. Clinics see status and outcomes rather than the agent's step by step trail.

SourceSilna Health, silnahealth.com/prior-authorization and engineering.silnahealth.com/posts/beyond-the-agentread 2026-10-06

Humata names no hosting region, no region choice and no option to run in the customer's own environment or on premises. Staff work inside the EHR through the native integration, and Humata does not say where the platform itself runs.

Sourcehumatahealth.com/security-and-complianceread 2026-09-29

The service is hosted. Its browser agents operate in sandboxed sessions on Silna's own self hosted Kasm Workspaces deployment, which isolates each session from the next and keeps agent activity off the clinic's own machines. There is no region choice, customer cloud or on premises option.

SourceSilna Health, silnahealth.com and engineering.silnahealth.com/posts/autonomous-browser-agents-enterpriseread 2026-10-06

The modular solution comes packaged for procedures, drugs and payers. It runs from auth requirements, PolicyLink and clinical bundling, through PolicyMatch, submission support and attestation assist, to statusing, post-auth monitoring, gold carding and AI clinical review. The customer assembles these modules as stages of one prior authorization workflow.

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Silna sells one Care Readiness Platform built from prior authorizations, benefit checks, insurance monitoring and payor discovery, with prior authorizations priced at $35 each. These work as parts of one service rather than separate agents a clinic switches on, and there is no template or agent library. Customers include Behavior One Autism Solutions, Autism Learning Partners, ABS Kids, AnswersNow, HealthPro Heritage and Elite Alliance Physical Therapy.

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Humata describes its technology only as NLP and AI. It names no model provider or model name, and no model choice for customers.

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Models are picked for each payer portal after testing cost, context window, intelligence and speed, and production traffic can be split between models that perform equally, for example half to Haiku 4.5 and half to GPT 5.4. The phone agents use Deepgram for speech recognition and ElevenLabs for speech, and the customer has no choice of model.

SourceSilna Health, engineering.silnahealth.com/posts/beyond-the-agent and /posts/building-phone-agents-healthcareread 2026-10-06

Customers get no API, SDK or MCP server to build on. Humata's proprietary APIs and its HL7 and FHIR interfaces connect it to EHRs, payers and UM systems.

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Authorizations can be followed from submission to approval through an API as well as Silna's dashboard, which gives a clinic's other systems a way to track them. There is no public API reference, SDK or MCP server, and the agents themselves work through payer portals, payer phone lines and Silna's own app.

SourceSilna Health, silnahealth.com/resources/best-prior-authorization-softwareread 2026-10-09

Clinical bundles start from historical submissions with staff review, and Humata adjusts their weights automatically from user behavior. The analytics and audit trail feed continuous improvement. This loop runs after deployment, and Humata names no measure or test set.

Sourcehumatahealth.com/use-cases/proceduresread 2026-09-29

An in house Experiments platform sets what share of prior authorizations each portal agent submits with no human touch and routes a share of agent submissions to human QA, comparing human and AI results, and specialist reviewers flag minor or major errors to build a dataset of where the agent was wrong. Models are tested per portal in a sandbox on production infrastructure for duration, token use and accuracy, and every session gets a score from 0 to 100 for execution quality, apart from its final outcome.

SourceSilna Health, engineering.silnahealth.com/posts/beyond-the-agentread 2026-10-06

Submission support includes a Portal Assistant alongside direct submission and eFax. Humata promises providers that staff no longer need portal logins, so the assistant acts inside payer portals where there is no API. Humata does not say how the assistant operates the portal.

Sourcehumatahealth.com/use-cases/proceduresread 2026-09-29

Browser agents work payer portals on their own, logging in with 2FA, navigating complex legacy interfaces, entering clinical data and recording approvals, across Blue Cross, Aetna, United and dozens of other portals, inside sandboxed browser sessions. They now handle nearly half of all prior authorizations and are trained to stop and ask for help rather than guess when stuck. Phone agents navigate payer phone menus to retrieve plan details.

SourceSilna Health, engineering.silnahealth.com/posts/autonomous-browser-agents-enterprise, /posts/beyond-the-agent and /posts/building-phone-agents-healthcareread 2026-10-06