TORONTO, CANADA - 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.