Banjo Health vs Forus (2026)
The two ends of a pharmacy prior authorization, automated separately. Banjo sits inside the plan or pharmacy benefit manager, reading prescriber notes directly and producing a structured recommendation with the evidence attached, backed by certification at the more demanding risk based tier. Forus sits at the point of prescribing, generating and submitting the authorization, drafting the appeal and routing to pharmacy, free to the provider. Between them a request can now be written by one model and adjudicated by another while a patient waits for a medicine. Neither publishes the number that would show its side is calibrated. And on Forus the question to ask first is who pays, because a free platform routing prescriptions has an economic relationship somewhere in the chain.
- It is pharmacy benefit weighted and reads prescriber notes directly, producing an inspectable structured recommendation with the evidence attached rather than a score.
- Certification is held at the risk based two year tier, which incorporates privacy requirements and is the more demanding assessment.
- For a plan or pharmacy benefit manager, the determination workflow is the constraint and this is built for it.
- It automates the provider's side of the same transaction, generating and submitting the authorization, drafting appeals and routing to pharmacy, at no cost to the prescriber.
- Coverage is stated as any drug, any insurance, any pharmacy, embedded at the point of prescribing rather than in a back office.
- It states plainly that protected health information is covered under a business associate agreement, alongside a typed attestation.
This comparison is published by AI Health Index, an independent research platform that compares healthcare AI vendors objectively. Banjo Health and Forus are each graded against the same capability taxonomy, from each vendor's own public materials and the regulatory record, under the AI Health Index verification standard. No vendor pays for placement, and no vendor has reviewed this page. How this evidence is graded
Plain facts
| Fact | Banjo Health | Forus |
|---|---|---|
| Primary category | RCM & Prior Auth AI | RCM & Prior Auth AI |
| Founded | Not recorded | 2022 |
| Headquarters | Washington, District of Columbia | New York, New York, United States |
| Website | banjohealth.com | forus.com |
Side by Side
Select any grade to read the note behind it.
Each vendor in one paragraph
Written to be quoted whole. Each paragraph opens the AI Health Index profile of the vendor: what the product is, who buys it and what it does.
Prior authorization, appeals and grievances platform for health plans and pharmacy benefit managers, across medical and pharmacy benefits. BanjoPA uses CARE (Computer Assisted Review Engine) to extract information from faxed and digital requests, create the case and match it against the plan's clinical criteria, recommending approve, deny or request more information with evidence and an explanation; a human reviewer confirms or adjusts every recommendation.
Source: AI Health Index, August 2026
Forus, formerly Tandem (renamed in May 2026 with no change in ownership), is a medication access platform that automates the path from prescription to therapy at the point of prescribing.
Source: AI Health Index, August 2026
Questions buyers ask
How do Banjo Health and Forus work with the EHR?
Banjo says it works with EHRs, eligibility verification tools, claims management systems, ePA vendors and API ready portals, ingests faxed and digital requests, and runs appeals through the same ePA vendor as the original request.
Forus says it integrates with all major or cloud-based record systems and picks up the prescription at the point of electronic prescribing; practices whose record system does not integrate can upload records when asked, and practices that do not e-prescribe are not yet supported. From the AI Health Index, drawn from each vendor's own published materials and the regulatory record, verified August 4, 2026. No vendor pays for placement.
How are Banjo Health and Forus priced and sold?
In Banjo Health's case, enterprise agreements with health plans and pharmacy benefit managers. CMS prior authorization rules are the stated adoption driver, so contracts may be negotiated under a compliance deadline, and the pricing page does not say whether pricing reflects the deadline driven implementation or steady state operation.
Forus says it is free for providers and patients, with no trial qualifier attached. The company describes itself as a network connecting doctors, pharmacies, payers and biopharma, and its privacy policy says it may sell anonymized data and aggregated insights to customers and other third parties. From the AI Health Index, drawn from each vendor's own published materials and the regulatory record, verified August 4, 2026. No vendor pays for placement.
How do Banjo Health and Forus handle patient data?
Banjo's October 2025 post states its AI is proprietary, designed from the ground up, and not an open source model, giving it control over every layer of the technology stack, so case data is not described as reaching an outside model provider. It also says the AI is constantly learning and adapting, which implies customer determinations improve the models, and nothing says whether that learning stays within one plan's boundary.
Forus says its platform is HIPAA compliant and that all protected health information is covered by a business associate agreement. Its privacy policy, updated May 2026, says it may create anonymized and aggregated information and 'may sell anonymized data and aggregated insights to customers and other third parties', and keeps personal information as long as needed for its purposes, including pharmacy regulations. From the AI Health Index, drawn from each vendor's own published materials and the regulatory record, verified August 4, 2026. No vendor pays for placement.
How much do Banjo Health and Forus leave to the clinician?
CARE recommends a determination (approve, deny or request more information) with detailed evidence and an explanation; Banjo states the ultimate decision stays with human experts, and its October 2025 post describes the workflow: the model evaluates each request and recommends, then a human reviewer confirms or adjusts it.
Forus says a clinician writes the prescription in the record as normal and Forus automatically generates and submits the prior authorization form, checks status with the plan, and routes the prescription to a pharmacy. When a request is denied the practice chooses the next step, such as starting an appeal that Forus drafts, and staff can follow every prescription in real time and step in. From the AI Health Index, drawn from each vendor's own published materials and the regulatory record, verified August 4, 2026. No vendor pays for placement.
Related comparisons
Other published head to head assessments involving these vendors or their closest peers.
One of these decides the authorization and the other submits it, which makes the pair a closed loop with a patient waiting inside it. Neither publishes the calibration number for its side: the proportion of AI informed denials overturned on appeal, and the proportion of automated submissions approved first time.
A product that is free to the provider is paid for by someone else, and in medication access that is usually a manufacturer or pharmacy channel, so establish who funds it and what data flows back. Neither publishes a bias evaluation, in a workflow where the output determines whether a patient starts therapy.