Banjo Health

JSON twin: https://www.healthaidb.com/software/banjo-health.json

Company Name

Banjo Health

Product URL

https://www.banjohealth.com

Company URL

https://www.banjohealth.com

Categories

• administrative Operations
• clinical Care
• patient Facing
• Administrative
• Clinical

Summary

Banjo Health offers AI-driven solutions to streamline prior authorization processes for health plans and pharmacy benefit managers, enhancing efficiency and decision-making speed.

Description

Banjo Health provides an AI-powered platform designed to manage medical and pharmacy prior authorization workflows, from requests to appeals. The platform integrates with electronic health records to automate decision-making, reducing administrative burdens and improving accuracy. Key features include Prior Authorization Workflows, Clinical Decision Tree Generator, and Appeals & Grievances Tool. The company has partnered with Jopari Solutions to enhance interoperability and with SmithRx to improve prior authorization workflows. Founded in 2019 and headquartered in Washington, D.C., Banjo Health has raised over $5 million in Series A funding and employs a team of 30+ professionals.

Api Available

yes

Certifications

• HITRUST Risk-based, 2-year (r2) certification
• FDA 510(k)
• CE/MDR
• ONC
• ISO 27001

Company Founding

2019

Company Offices

• United States

Compliance

• HIPAA
• HITRUST
• CMS Interoperability and Prior Authorization Final Rule (CMS-0057-F)
• SOC 2
• ISO 27001

Customers

• PBMs
• Health Plans
• Partners

Data Residency

US/EU regions

Data Standards

• FHIR
• HL7 v2
• DICOM
• SNOMED
• ICD-10

Deployment Model

• SaaS

Features

• AI-powered prior authorization management
• End-to-end case management for prior authorizations and appeals
• Clinical decision tree generator
• Automated decision-making
• Real-time case creation
• Intelligent decisioning
• Automated case routing
• Compliance management
• Audit readiness
• Operational efficiency
• Resource optimization
• Member experience enhancement
• Regulatory compliance
• Clinical workflow management
• Sandbox testing environment
• Interoperability with existing systems
• Automated prior authorization workflows
• Real-time access to case information
• Secure data management
• Transparent reporting

Id

SW0975

Integration Partners

• EHRs
• eligibility verification tools
• claims management systems
• ePA vendors

Integrations

• Surescripts
• CoverMyMeds
• Cencora
• Arrive Health
• EHRs
• Eligibility verification tools
• Claims management systems
• ePA vendors
• API-ready portals

Languages Supported

• English

Last Updated

2025-10-11

License

commercial

Market Segment

• enterprise
• smb

Optional Modules

• BanjoPA
• BanjoA&G
• Composer
• Composer Connect

Os Platforms

• Web

Pricing Details

contact vendor

Pricing Model

subscription

Privacy Features

• Business Associate Agreement (BAA) available
• Consent management
• Anonymization
• Data minimization

Product Code

SW0975

Product Name

Banjo Health

Ratings

Regions Available

• United States

Related Urls

• https://elion.health/products/banjo-health

Release Year

2020

Security Features

• End-to-end encryption
• Role-based access control (RBAC)
• Single Sign-On (SSO)
• Audit logs
• Two-factor authentication (2FA)
• Data loss prevention (DLP)

Specialties

• Prior Authorization Management
• Healthcare Workflow Optimization
• Ai In Healthcare

Support Channels

• email
• phone
• chat
• ticketing
• community
• 24x7

System Requirements

Target Users

• health plans
• pharmacy benefit managers
• providers
• patients

Training Options

• documentation
• webinars
• live_online
• onsite
• certification

Type

product

User Reviews

Version

1.0

Alternatives

See related products

Canonical JSON

{
  "product_name": "Banjo Health",
  "company_name": "Banjo Health",
  "product_url": "https://www.banjohealth.com",
  "company_url": "https://www.banjohealth.com",
  "related_urls": [
    "https://elion.health/products/banjo-health"
  ],
  "product_code": "SW0975",
  "summary": "Banjo Health offers AI-driven solutions to streamline prior authorization processes for health plans and pharmacy benefit managers, enhancing efficiency and decision-making speed.",
  "description": "Banjo Health provides an AI-powered platform designed to manage medical and pharmacy prior authorization workflows, from requests to appeals. The platform integrates with electronic health records to automate decision-making, reducing administrative burdens and improving accuracy. Key features include Prior Authorization Workflows, Clinical Decision Tree Generator, and Appeals & Grievances Tool. The company has partnered with Jopari Solutions to enhance interoperability and with SmithRx to improve prior authorization workflows. Founded in 2019 and headquartered in Washington, D.C., Banjo Health has raised over $5 million in Series A funding and employs a team of 30+ professionals.",
  "categories": [
    "administrative Operations",
    "clinical Care",
    "patient Facing",
    "Administrative",
    "Clinical",
    "Patient-facing"
  ],
  "market_segment": [
    "enterprise",
    "smb"
  ],
  "target_users": [
    "health plans",
    "pharmacy benefit managers",
    "providers",
    "patients"
  ],
  "specialties": [
    "Prior Authorization Management",
    "Healthcare Workflow Optimization",
    "Ai In Healthcare"
  ],
  "regions_available": [
    "United States"
  ],
  "languages_supported": [
    "English"
  ],
  "pricing_model": "subscription",
  "pricing_details": "contact vendor",
  "license": "commercial",
  "company_offices": [
    "United States"
  ],
  "company_founding": "2019",
  "deployment_model": [
    "SaaS"
  ],
  "os_platforms": [
    "Web"
  ],
  "features": [
    "AI-powered prior authorization management",
    "End-to-end case management for prior authorizations and appeals",
    "Clinical decision tree generator",
    "Automated decision-making",
    "Real-time case creation",
    "Intelligent decisioning",
    "Automated case routing",
    "Compliance management",
    "Audit readiness",
    "Operational efficiency",
    "Resource optimization",
    "Member experience enhancement",
    "Regulatory compliance",
    "Clinical workflow management",
    "Sandbox testing environment",
    "Interoperability with existing systems",
    "Automated prior authorization workflows",
    "Real-time access to case information",
    "Secure data management",
    "Transparent reporting"
  ],
  "optional_modules": [
    "BanjoPA",
    "BanjoA&G",
    "Composer",
    "Composer Connect"
  ],
  "integrations": [
    "Surescripts",
    "CoverMyMeds",
    "Cencora",
    "Arrive Health",
    "EHRs",
    "Eligibility verification tools",
    "Claims management systems",
    "ePA vendors",
    "API-ready portals"
  ],
  "data_standards": [
    "FHIR",
    "HL7 v2",
    "DICOM",
    "SNOMED",
    "ICD-10"
  ],
  "api_available": "yes",
  "system_requirements": "",
  "compliance": [
    "HIPAA",
    "HITRUST",
    "CMS Interoperability and Prior Authorization Final Rule (CMS-0057-F)",
    "SOC 2",
    "ISO 27001"
  ],
  "certifications": [
    "HITRUST Risk-based, 2-year (r2) certification",
    "FDA 510(k)",
    "CE/MDR",
    "ONC",
    "ISO 27001"
  ],
  "security_features": [
    "End-to-end encryption",
    "Role-based access control (RBAC)",
    "Single Sign-On (SSO)",
    "Audit logs",
    "Two-factor authentication (2FA)",
    "Data loss prevention (DLP)"
  ],
  "privacy_features": [
    "Business Associate Agreement (BAA) available",
    "Consent management",
    "Anonymization",
    "Data minimization"
  ],
  "data_residency": "US/EU regions",
  "customers": [
    "PBMs",
    "Health Plans",
    "Partners"
  ],
  "user_reviews": [],
  "ratings": [],
  "support_channels": [
    "email",
    "phone",
    "chat",
    "ticketing",
    "community",
    "24x7"
  ],
  "training_options": [
    "documentation",
    "webinars",
    "live_online",
    "onsite",
    "certification"
  ],
  "release_year": "2020",
  "integration_partners": [
    "EHRs",
    "eligibility verification tools",
    "claims management systems",
    "ePA vendors"
  ],
  "id": "SW0975",
  "slug": "banjo-health",
  "type": "product",
  "version": "1.0",
  "last_updated": "2025-10-11",
  "links_json": {
    "self": "https://www.healthaidb.com/software/banjo-health.json"
  }
}