Smile Digital Health Reinforces Commitment to Simplifying Prior Authorization for Millions of Americans

TORONTO, ONTARIO / ACCESS Newswire / June 27, 2025 / Smile Digital Health (Smile), a leading health data platform provider, today reaffirmed its commitment to streamlining the prior authorization process through interoperable, standards-based solutions. This announcement follows a sweeping initiative endorsed by U.S. health insurers and policymakers to simplify and digitize prior authorization workflows for improved patient access and care delivery.

Smile Digital Health is a long-standing technology partner to more than 10 of the health plans that recently pledged alignment with six key actions to improve prior authorization, as outlined by America’s Health Insurance Plans (AHIP). Collectively, these 10 organizations cover over 100 million individuals in the United States, representing a significant share of the population set to benefit from more transparent, data-driven, real-time authorization pathways.

As part of its commitment, Smile enables payers and providers to operationalize prior authorization using interoperable standards such as HL7^® FHIR^® and the HL7^® Da Vinci Coverage Requirements Discovery (CRD), Documentation Templates and Rules (DTR), and Prior Authorization Support (PAS) implementation guides in accordance with the CMS-0057-F Rule. These tools reduce administrative burden and accelerate decision-making by allowing clinical and coverage data to flow seamlessly between stakeholders.

“At Smile, we build healthcare technology that’s ready for tomorrow,” said Duncan Weatherston, CEO of Smile Digital Health. “We’re helping payers and providers take this challenge head-on, cutting friction, reducing delays, and delivering on the promise of connected, patient-centered care.”

Smile’s Health Data Platform integrates with payer systems to support end-to-end workflows, including prior authorization submission, clinical documentation retrieval, and real-time decision response. Through these capabilities, Smile contributes directly to industry goals of improving timeliness, reducing friction, and delivering more equitable access to care.

As federal momentum continues to build around prior authorization reform, Smile Digital Health remains at the forefront, empowering payers and providers to align with national priorities and deliver more connected, patient-centered care.

The original AHIP announcement is available here.

About Smile Digital Health

Smile Digital Health is a FHIR®-first health data solutions company that provides the most advanced platform for managing and exchanging healthcare data. Smile helps healthcare organizations drive better patient outcomes, improve operational efficiency, and foster deeper collaboration across the healthcare ecosystem. Our enterprise-grade, open framework data platform drives data unification, enrichment, and elevation while ensuring compliance with industry mandates. We equip healthcare providers, payers, researchers, and life sciences organizations for a connected future beyond legacy systems, unlocking new value through the intelligent use of information, and creating #BetterGlobalHealth overall. For more information, visit SmileDigitalHealth.com or on LinkedIn.

Contact Information

Jenifer Baird
Vice President of Sales Enablement and Marketing, Smile Digital Health
pr@smiledigitalhealth.com
+1 877 537 3343

SOURCE: Smile CDR Inc. (doing business as Smile Digital Health)

View the original press release on ACCESS Newswire