New platform streamlines prior authorization, accelerates decisions, improves member experience and outcomes, and enables health plans to meet CMS compliance requirements

SAN FRANCISCO: Innovaccer, a leading healthcare AI company, today announced the launch of Innovaccer Galaxy UM, an AI-powered utilization management platform designed to help health plans automate prior authorization, reduce administrative costs, and improve care delivery outcomes.

Prior authorization remains one of the most complex and resource-intensive processes in healthcare, with a significant share of requests still handled through manual workflows such as fax and phone. These inefficiencies contribute to delays in care, increased provider burden, member dissatisfaction, and rising operational costs for payers. At the same time, new regulatory requirements are placing added pressure on health plans to meet stricter turnaround timelines and reporting standards.

Innovaccer Galaxy UM addresses these challenges by automating the end-to-end utilization management lifecycle. The platform enables health plans to receive requests across multiple channels, extract and structure clinical data, evaluate medical necessity against payer-specific policies, and communicate decisions to providers in real time.

“Utilization management should enable better care, not delay it,” said Abhinav Shashank, cofounder and CEO of Innovaccer. “With Galaxy UM, we are bringing together AI and clinical intelligence to streamline prior authorization, reduce administrative burden, and ensure that decisions are faster, more transparent, and aligned with patient needs. This is another step in our vision towards autonomous healthcare."

Powered by agentic AI, Galaxy UM orchestrates workflows across the prior authorization process, from intake to decision-making and communication. The platform uses advanced natural language processing and optical character recognition to analyze unstructured clinical documents, enabling faster and more accurate case evaluations.

A core design principle of Galaxy UM is its commitment to clinical oversight. The platform follows an “only auto-approve, never auto-deny” approach, ensuring that any case requiring further review is routed to qualified clinicians. This supports transparency, reduces the risk of inappropriate denials, and strengthens trust between members, payers, and providers.

Galaxy UM is built to support compliance with evolving regulatory requirements, including CMS-0057. The platform provides automated turnaround tracking, comprehensive audit trails, and reporting capabilities that help health plans meet mandated timelines and transparency standards.

Built on Innovaccer’s Health Cloud, the platform enables unified access to clinical, claims, and operational data, improving decision accuracy and helping organizations identify avoidable utilization while scaling efficiently.

Innovaccer Galaxy UM is available in limited beta, with general availability expected later in 2026.

For more details, visit https://innovaccer.com/solutions/utilization-management.

About Innovaccer

Innovaccer is the AI infrastructure for autonomous healthcare operations, delivering better clinical and financial outcomes across health systems, payers, governments, and life sciences. Powered by the Healthcare Intelligence Platform, Innovaccer unifies enterprise data and applies AI to automate administrative work, strengthen operational performance, and drive measurable margin expansion. Organizations such as Orlando Health, Adventist HealthCare, and Banner Health trust Innovaccer to integrate intelligence into their existing infrastructure and elevate the quality of care. For more information, visit www.innovaccer.com.

Fonte: Business Wire