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Access to all Payer medical policies with Policy Alerts

Comprehensive reports provide you with the detailed coverage information you need.

Review medical policies and update notification history

Every Payer medical policy pertaining to your product will be displayed online in the Dashboard Payer Policy Report. This report includes the Policy Status, Coverage Status, Payer Name, Insured Lives, Policy Title, URL, Title Number, Recent Review Date, Effective Date, Upcoming Review Date, and the Coverage Statement. Additional columns can be added and customized reports can be created.

Our reports are organized by the following 3 Policy types; Draft, Pending, and Active.

  • Draft Policy: Policy posted prior to approval & implementation to allow input from network providers and patients.
  • Pending Policy: An approved policy not yet implemented with a future effective date.
  • Active Policy: Final policy approved and implemented until the next future review date.

Each policy listed on the the Payer Policy Report is categorized by the following Coverage Statuses; Positive, Negative, No Policy, Not Mentioned, Unknown.

  • Positive: Medically Necessary or Covered.
  • Negative: Experimental, Investigational or Non-Covered.
  • No Policy: No medical policy coverage statement.
  • Not Mentioned: Coverage not specifically stated in medical policy.
  • Unknown: Medical policy coverage statement not accessible.

Payer review dates can be complicated. While most payers review medical policies on an annual basis, there are many reasons why a Payer might review or update a policy out of cycle. In order to provide more clarity, we provide several unique dates from each policy.

  • Policy Updated: Date the policy was most recently revised or reviewed by the medical policy committee.
  • Posted Date: Date the medical policy became publicly available on the Payer website.
  • Effective Date: Date the medical policy will be implemented.
  • Future Review: Anticipated or known date the policy will be formally reviewed by the medical policy committee.

In addition to these helpful categories and fields, all of our reports can be easily sorted and filtered so you only see the information you need. Quickly and easily export the Payer Policy Report into an excel workbook to share with your team. Everything you see if fully customizable based on project need.

User-friendly features to save you time

Never miss another medical policy update or coverage position change again. Receive update alerts daily, along with weekly and monthly summary reports of all reviews and updates.

Payer medical policy committee reviews and changes can occur out of schedule and often go unnoticed. While most Payers typically update medical policies on an annual review schedule, there are many reasons a Payer will change a policy out of cycle. Policy Alerts keeps you informed of both anticipated and unexpected changes affecting your product. Being able to quickly review the changes Payers make to their medical policies allows you to be proactive and better understand the Payer decisions impacting your business.

Policy Alerts takes a client-focused hands-on approach. We work hard to provide our customers with intelligence over raw data and understand what our clients need. We are dedicated to to providing timely, accurate, and intelligent insights that can be used to implement and support a successful reimbursement strategy.

Clients can easily access and review their Payer medical policies online. Our software automatically generates useful reports and analyses from the medical policy and coverage information being monitored. Interactive Payer coverage charts and graphs are available on the Policy Alerts Payer Coverage Analytics Dashboard. Let Policy Alerts perform the complex and time-consuming task of monitoring your product’s medical policies and free up your team’s resources to focus on a successful product launch and reimbursement strategy.

Find out how Policy Alerts helps keep you focused
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