CMS-0057 compliance is the starting line, not the finish line — and CMS-0062 is already on the way. Here’s the question health plan leaders should be asking right now.

Washington has enacts a comprehensive law designed to modernize prior authorization practices in response to longstanding prior authorization concerns.

Welcome Shawn Kearl as Chief Revenue Officer at Banjo Health!

Discover how Banjo Health’s Composer transforms clinical criteria into AI-powered decision trees to reduce prior authorization burden, cost, and review time.

BanjoA&G unifies patient context and end-to-end case management to help health plans resolve appeals and grievances faster, with less manual effort and greater confidence.

Our seamless claims system integration streamlines prior authorizations with unified patient history, test claims, and automated overrides—cutting admin burden, speeding decisions, and improving care seamless claims system integration streamlines prior authorizations with unified patient history, test claims, and automated overrides—cutting admin burden, speeding decisions, and improving care

California’s SB 41 is putting prior authorization under direct regulatory scrutiny starting in 2026–2027, and Banjo Health helps plans and PBMs stay compliant with audit-ready, evidence-based, faster PA automation and reporting.

A Day in the Life of a PBM PA Coordinator as told by a Current Banjo Health Customer

CARE speeds prior authorization reviews by surfacing the right clinical evidence—reducing rework and turnaround time while keeping clinicians fully in control.

A Day in the Life of a PA Coordinator, as told by a current Banjo Health customer

Automated, compliant letter generation that saves case managers time, eliminates errors, and ensures the right message reaches the right stakeholder—every time.

Big news from Banjo!

With the upcoming CMS mandates, PBMs need to look ahead to rethink their PA workflows. Let BanjoPA help!