Oracle Health announced on September 23 that it is expanding native AI across its revenue-cycle portfolio, with planned capabilities covering:
- Prior authorization
- Professional-fee coding
- Clinical documentation integrity
- Appeal management
- Charge capture
The features are planned for general availability in the coming months. Oracle explicitly labels them as future product direction.
Separately, Surescripts announced on September 24 that its prescription prior-authorization automation will be integrated into Oracle Health workflows, with general availability planned for 2027.
The two announcements are closely related but cover different scopes of authorization work.
Oracle and Surescripts are moving prior auth in the same direction
Oracle’s broader AI covers the medical prior-authorization workflow — checking coverage requirements, retrieving payer documentation rules, pre-filling authorization information, attaching supporting evidence, coordinating authorization activity, and supporting payer interactions.
Oracle positions this as part of a larger RCM strategy extending from scheduling and financial clearance through documentation, billing, and payment.
Surescripts’ product is narrower and more concrete. It handles prescription medications specifically — retrieving clinical information from the patient’s EHR at the time of prescribing, matching it against authorization criteria and transmitting the required information electronically to the pharmacy benefit manager.
| Announcement | Scope | Planned availability |
| Oracle Health AI for RCM | Medical prior auth, documentation, charge capture, coding, appeals | Coming months |
| Oracle + Surescripts | Prescription-medication prior authorization within Oracle Health | 2027 |
Source: Oracle, Surescripts
The two should not be described as one product.
Oracle’s existing product documentation for its Intelligent Prior Authorization says generative AI can draft prior-authorization summaries, but users are instructed to review generated information for accuracy before submission.
The CMS electronic PA deadline is closing in
The timing connects directly to CMS-0057-F. Beginning January 1, 2027, certain CMS-regulated health plans must implement a standardized Prior Authorization API that makes coverage requirements available, identifies documentation needs, and supports electronic authorization requests and responses.
The affected payer categories include:
- Medicare Advantage organizations
- Medicaid and CHIP managed-care plans,
- State Medicaid and CHIP fee-for-service programs
- Qualified Health Plan issuers on federally facilitated exchanges
CMS is already telling providers to work with their EHR vendors on API readiness, upgrades, testing, workflow redesign, and staff training before the January implementation point.
CMS requires covered payers to issue decisions within 72 hours for expedited requests and seven calendar days for standard requests (effective 2026).
Meanwhile, CMS-0057-F excludes prescription drugs from its 2027 PA API requirements
A separate proposed rule (CMS-0062-P, published April 10, 2026) would expand electronic PA requirements to drugs, with proposed compliance dates beginning October 1, 2027 — but it has not been finalized
PRIOR AUTHORIZATION BURDEN — AMA 2025 SURVEY
What 1,000 physicians reported
40
PAs handled per physician per week
13
hours per week consumed
95%
say PA delays necessary care
79%
report patients abandoning treatment
Source: AMA 2025 Prior Authorization Physician Survey (published May 2026). Physician-reported findings, not independently measured payer statistics.
The 18-second figure
Surescripts reports a median approval time of 18 seconds for its prescription PA automation — but only when all authorization criteria are met for supported medications. It does not mean every prescription prior authorization will take 18 seconds.
When the patient’s clinical information does not satisfy available criteria, the prescriber is prompted to complete the request manually instead.
Surescripts says the technology has reached more than 76,000 prescribers and supports more than 70 medications, with health systems including (already using it):
- UNC Health
- Cleveland Clinic
- The Ohio State University Medical Center
What is new now is availability of that technology through Oracle Health’s workflow, not the creation of Surescripts’ prescription PA automation itself.
AI on both sides
The story has a built-in tension. Oracle argues AI can reduce provider administrative work by identifying requirements and preparing documentation before authorization issues become denials. But physicians have expressed concern about AI on the payer side.
In the AMA’s 2025 survey, six in ten physicians said they worried that AI could further increase prior-authorization denials.
AI used by providers to assemble complete authorization requests is a different tool from AI used by payers to adjudicate whether a request should be approved.
Oracle’s announcement emphasizes the former — discovering requirements, gathering evidence, preparing requests
Neither Oracle nor Surescripts described a system that independently submits every authorization with no human review.
CMS’s electronic PA guidance estimates that PA requests cost providers approximately $34,000 and 700 administrative hours per provider annually.
CAQH’s 2024 Index estimated that adopting the electronic PA standard could save the medical industry approximately $515 million annually.
