6 Best SamaCare Alternatives in 2026

A quick word on SamaCare itself

Before walking through the alternatives, it helps to be precise about what SamaCare does and does not do, since most of the alternative shortlists in 2026 are shaped by these boundaries. SamaCare is an AI-native prior authorization platform built specifically for medical-benefit drug authorizations. Its strengths are clinical pathway coverage for oncology infusion regimens, rheumatology biologics, neurology, GI, and ophthalmology drug PA, plus integrations into provider EHRs that surface the right drug PA workflow at the right point in the patient journey. SamaCare has expanded its distribution through its AmerisourceBergen partnership and is referenced in 2026 PA software roundups by Linear Health and OmniMD among others. The product is free for practices because pharmaceutical manufacturers fund the platform, which is a real wedge on price but also bounds the product's scope: SamaCare does not cover surgical PA, imaging PA, DME PA, eligibility verification, denial appeals, or outbound payer voice work. None of that is a criticism. It is the product's scope. The six alternatives below extend into different parts of the workflow that SamaCare is not built for.

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1. Tennr - Best for referral, intake, and faxed-document automation

Tennr is the AI document and intake platform that sits one step before prior authorization. Its core product turns inbound referrals, faxes, and patient documents into structured data the practice can act on. For specialty practices where a high percentage of PA work begins with a faxed referral or a scanned chart packet, Tennr is upstream of SamaCare and complementary to it. Many groups run Tennr to clean intake and another tool to submit PA.

Best For

Specialty practices and ASCs where inbound referrals and faxed documents are the entry point for the visit. Strong fit for ortho, GI, ophthalmology, and infusion centers that receive a constant stream of referral packets.

Key Features

• Document AI for inbound faxes, referrals, and scanned chart packets.
• Structured data extraction directly into the EHR record.
• Referral routing and triage workflows.
• EHR integrations across major systems for write-back.

How Tennr compares to SamaCare

Tennr does not submit PA. It cleans up what comes in the door so the PA team has structured data to work with. SamaCare submits drug PA but does not handle intake. The two are complementary rather than competitive. Practices commonly run Tennr for intake plus SamaCare for drug PA, or Tennr plus Flexbone for broader PA coverage.

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2. Cohere Health - Best for payer-side utilization management

Cohere Health is primarily a payer-side platform. Its intelligent prior authorization product is contracted by health plans to handle utilization management decisions across medical and procedural PA. Providers interact with Cohere through a portal when their patients' health plan uses Cohere for PA. For a specialty practice, Cohere is not a tool you buy directly. It is a tool you encounter when submitting PA to certain payers.

Best For

Health plans and payer operations teams that want to modernize utilization management with evidence-based pathways and clinical decision support. Providers see Cohere through the payer-side portal.

Key Features

• Evidence-based clinical pathways for utilization management.
• Intelligent PA review with clinical decision support.
• Provider-facing portal for PA submission against participating health plans.
• Payer analytics and outcomes reporting.

How Cohere compares to SamaCare

SamaCare is bought by practices to submit drug PA out. Cohere is bought by payers to receive and process PA in. The two operate on different sides of the same transaction. A specialty practice that uses SamaCare might still submit through Cohere's portal for certain plans, and that workflow lives in Cohere whether SamaCare is in the stack or not.

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3. Rhyme - Best for electronic PA exchange across payers

Rhyme operates as a network connecting providers and payers for electronic prior authorization across medical, procedural, and drug PA. Its model is "electronic PA, not phone or fax." Providers connect through Rhyme to submit PA electronically to payers that have joined the network, and payers process those submissions through Rhyme's infrastructure. For specialty groups whose PA mix spans more categories than SamaCare covers, Rhyme is a useful exchange layer.

Best For

Health systems, large specialty groups, and payers wanting to shift PA volume off phone and fax onto electronic exchange. Strongest where the payer mix overlaps with Rhyme's network.

Key Features

• Electronic PA submission across medical, procedural, and drug categories.
• Payer network connectivity for participating plans.
• Integration with EHR systems for chart data and submission.
• Real-time PA status visibility on participating payers.

How Rhyme compares to SamaCare

SamaCare focuses on drug PA, primarily for medical-benefit infusions and biologics. Rhyme covers a wider PA mix and is built around electronic exchange. The right fit depends on payer mix. If most of your PA submissions go to payers Rhyme connects, Rhyme is broader than SamaCare. If most of your work is medical-benefit drug PA, SamaCare's narrower focus and free-for-practices model is hard to beat on price alone.

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4. Thoughtful AI - Best for agentic RCM automation

Thoughtful AI builds agentic automation across revenue cycle workflows, including PA, eligibility, claims submission, payment posting, and denials. Its product is positioned as digital workers that take over discrete RCM tasks rather than a single workflow tool. For specialty practices and groups that want to automate multiple RCM steps under one vendor, Thoughtful is a broader alternative to SamaCare.

Best For

Multi-specialty groups, MSOs, and RCM operations teams that want a single vendor across PA, eligibility, claims, and posting rather than stacking point tools.

Key Features

• Agentic automation for PA submission and follow-up.
• Eligibility verification and benefits checking, including coverage discovery.
• Claims submission, scrubbing, and payment posting.
• Denials triage, root-cause analysis, and appeal initiation.
• EHR and billing system integrations across major platforms.

How Thoughtful AI compares to SamaCare

SamaCare is the narrowest tool in this comparison: medical-benefit drug PA, free for practices. Thoughtful AI is one of the broadest: paid, multi-workflow RCM automation. Specialty practices that need only drug PA usually stay on SamaCare since the price is right. Groups whose pain extends across eligibility, claims, and denials evaluate Thoughtful, Adonis, or Flexbone instead.

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5. Adonis - Best for end-to-end RCM intelligence

Adonis is an RCM intelligence and automation platform that covers eligibility, PA, claims, denials, and payment posting, with a strong analytics layer on top. Its positioning leans on financial outcomes: cash collected, denial reduction, and AR days. For specialty groups and MSOs that view RCM as a financial discipline rather than a workflow problem, Adonis is the analytics-led alternative.

Best For

Specialty groups, MSOs, and RCM operations teams where the CFO and revenue cycle leader want financial dashboards alongside workflow automation. Strong fit for multi-location groups that need to benchmark across sites.

Key Features

• Eligibility verification with benefits and patient responsibility calculation.
• PA workflow automation.
• Claims submission, scrubbing, and payment posting.
• Denial analytics and root-cause reporting.
• Financial dashboards and benchmarks across locations.

How Adonis compares to SamaCare

SamaCare is a focused drug PA tool. Adonis is a broader RCM intelligence platform. Specialty groups with both deep drug PA volume and complex multi-location finances often run both: SamaCare for free drug PA submission, Adonis for the rest of the revenue cycle and analytics. Groups that want one vendor across PA, eligibility, claims, and denials usually pick Adonis, Thoughtful, or Flexbone over stacking SamaCare with point tools.

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6. Flexbone AI - Best for broader PA scope plus eligibility, denials, and voice

Flexbone is on this list because specialty practices that bump into the edges of SamaCare's scope (procedural PA, DME, eligibility verification, denial appeals, outbound payer voice) commonly evaluate Flexbone to cover the rest. Where SamaCare is a focused medical-benefit drug PA platform funded by pharma, Flexbone is a paid, provider-side AI ops layer covering medical, procedural, and DME PA plus eligibility, denials, and voice work. The comparison is on scope, not price.

Best For

Specialty practices and MSOs in oncology, rheumatology, neurology, GI, ophthalmology, ortho, plastic surgery, derm, OB/GYN, and infusion centers whose PA workload spans drug, procedural, and DME categories, and whose staff also handles eligibility verification, denial appeals, and outbound payer voice. Strong fit for groups on athenahealth, ModMed, eClinicalWorks, NextGen, Tebra, Dentrix, PointClickCare, HST, SIS, and other EHRs where SamaCare's drug-focused workflow is one slice of a larger queue.

Where Flexbone fits in a SamaCare evaluation

SamaCare answers one question well: medical-benefit drug PA, free for the practice. Flexbone answers a broader question at a price: how do you stop hiring more PA coordinators, verification specialists, and denial appeal writers, and still cover the full PA surface? If drug PA is the only workload and the team can fit it, SamaCare alone is the right call on price. If the workload extends into procedural PA for surgeries and injections, DME authorizations, eligibility verification, denial appeals, and outbound payer voice, the buying conversation moves to scope and total staff time recovered. Flexbone is built for that conversation.

Key Features

• Prior authorization automation covers medical, procedural, and DME PA, including portal submission, faxed payer follow-up, and chart-data extraction from the EHR. Covers oncology drug PA scope and adds surgical, imaging, and DME categories SamaCare does not.
• Eligibility verification unifies 270/271, payer portal, and IVR data into one structured record per patient, with patient responsibility calculated against contract rates.
• Denials management ingests denial letters, drafts appeals, builds Revenue Management Tasks, and pushes corrected claims back to clearinghouses.
• Healthcare Calls handles outbound payer voice for PA status checks, peer-to-peer scheduling, and benefits clarifications, plus inbound patient calls for scheduling and confirmations.
• AI Patient Coordinator turns inbound web and call inquiries into booked appointments 24/7, sitting in front of the PA workflow rather than competing with it.

Strengths

• Broader PA scope than SamaCare. Medical, procedural, and DME PA under one platform rather than drug-only.
• Bundles eligibility, denials, and voice. SamaCare buyers stack separate tools for those workflows; Flexbone covers them in one platform.
• Forward-deployed engineering model means each agent is fitted to the customer's exact EHR, payer mix, and specialty workflow. The 16 documented EHR integrations include systems most PA vendors do not lead on, including HST, SIS, PointClickCare, and Dentrix.
• Provider-side and not pharma-funded. Practices that prefer to keep PA decisions independent of pharma funding incentives gain that separation. Specialty depth across orthopedic practices and dental and oral surgery covers segments outside SamaCare's drug PA focus.
• Zero-retention security architecture processes and discards patient data rather than warehousing it, which simplifies compliance review.

Limitations

• Flexbone is paid. SamaCare is free for practices. If drug PA is the entire workload and the staff can fit it, SamaCare alone is the right call on cost. The Flexbone case is scope and total staff hours recovered, not unit price on drug PA.
• Flexbone is not an ambient clinical scribe. Documentation workflows need a separate tool.

Pricing

Custom pricing tied to scope, EHR mix, and payer workload. Customers commonly report $250,000+ per year in recovered staff time and denied-revenue capture. Contact the Flexbone team for a tailored quote.

How Flexbone compares to SamaCare

SamaCare and Flexbone do not compete on price. SamaCare is free for practices because pharma funds the platform. Flexbone is paid because the practice funds the platform. The relevant comparison is scope and total recovered staff time. SamaCare covers medical-benefit drug PA. Flexbone covers medical PA (including drug), procedural PA, DME PA, eligibility verification, denials management, and outbound payer voice. For a specialty practice whose only PA workload is medical-benefit infusions and biologics, SamaCare alone is rational. For a specialty practice whose PA workload spans drug, procedural, and DME, and whose staff also handles eligibility and denials, the right comparison is total staff hours saved per year against the Flexbone subscription, not unit price on drug PA.

A worked example for a multi-specialty group

Take a mid-sized multi-specialty group running infusion, rheumatology, and orthopedic surgery across four locations on athenahealth and ModMed. The PA workload looks like this. One staff member handles drug PA for infusion and biologics. Two staff members handle surgical PA, imaging PA, and DME authorizations for the ortho line. Another two handle eligibility verification across all three specialties. A sixth works denial appeals across the group. Six full-time roles, three of which touch PA in some form. SamaCare can absorb the drug PA work for free, which is a real win for the first role. It does not help the other five roles, which together represent more staff hours than the drug PA work. A broader platform like Thoughtful AI, Adonis, or Flexbone targets all six roles. The buying conversation is not "SamaCare free vs Flexbone paid for drug PA." It is "what does it cost to keep the entire six-person back-office, and what subscription is rational against the share of those hours an AI platform can absorb?" Once the comparison is framed that way, the SamaCare free wedge is real but small relative to the broader staff cost the practice is carrying anyway. Different groups land in different places. Single-specialty oncology and rheumatology practices whose PA workload is almost entirely medical-benefit drug can rationally stay on SamaCare alone. Multi-specialty groups whose PA mix spans drug, procedural, and DME, and whose staff also handles eligibility and denials, usually find a broader platform pays back faster than a free narrower one.