Dr. Shiv Rao: Abridge and Availity Aim to Shrink Prior Authorization From Months to Minutes
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This is an AI-assisted summary of my Fortt Knox Update with Abridge CEO Dr. Shiv Rao. View the full interview here:
Jon Fortt sits down with Shiv Rao, founder and CEO of Abridge, to unpack a newly announced partnership with Availity that targets one of healthcare’s most painful bottlenecks: prior authorization. Rao explains that prior auth today is a slow, sequential process that forces clinicians to document, submit, revise, and resubmit information long after a patient visit. That creates delays and wasted effort for doctors, patients, and insurers alike.
The Abridge–Availity integration moves this work upstream, directly into the doctor-patient conversation. By combining real-time conversational AI with Availity’s payer APIs and longitudinal medical records, Abridge can prompt clinicians to ask the right questions, surface contraindications and generate the necessary documentation as the visit unfolds. The result is a parallelized workflow where approval steps happen in minutes instead of weeks or months.
Rao emphasizes that this is not about removing humans from care. Healthcare remains fundamentally relational, but AI can automate the invisible administrative work that distracts from patient outcomes. With Abridge already live across more than 200 health systems and on pace for roughly 80 million clinical encounters this year, the partnership enables experimentation across regions, specialties, and care settings. Over time, Rao says, the goal is not just efficiency and cost reduction, but measurable improvements in patient outcomes, using the clinical conversation as the foundation for a more connected healthcare ecosystem.
Highlights
Prior authorization is reframed as a real-time, in-visit process, not post-visit paperwork.
Abridge uses conversational AI plus payer APIs to prompt clinicians and close documentation gaps.
The approach parallelizes workflows that are traditionally slow and sequential.
Availity provides broad payer connectivity, enabling one-to-many insurer integration.
Abridge is live across 200+ health systems, touching millions of encounters weekly.
Rollout will vary by geography, specialty, and care setting.
The long-term aim goes beyond efficiency to demonstrable outcome improvement.
If you’d like to join me – and peers – for deeper conversations on innovation and leadership, get on this list for Fortt Knox Executive Communities, launching soon: mba.fortt.com.
This is super compelling stuff on the prior auth problem. The idea of moving authorization upstream into the actual visit instead of post-visit paperwork is lowkey genius because it fixes the problem at the source rather than trying to speed up broken processes afterwards. I've seen so many delays in my own familys healthcare where we're waiting weeks for authorizations while treatments sit idle. Shifting from sequential to paralell workflows seems like the kind of fundamental rethink that actually moves the needle.