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These documents clearly indicate whether the case fully satisfies policy criteria or materially meets criteria, allowing staff to proactively clarify missing elements before submission.

This materially reduces preventable errors, improves initial approval rates, minimizes delays, and supports downstream denial prevention. It also ensures that reviewers on the payer side clearly understand that proton therapy is covered under the member’s specific plan and that the supporting rationale is evident from the outset.

Built for both Medicare Advantage and commercial insurance plans.

P2P Co-Pilot™ addresses this directly. By matching the patient-specific policy criteria to the loaded consult note and generating a concise case-specific “cheat sheet,” the platform equips the treating physician with the relevant policy language, guideline support, key trial data, the most persuasive medical necessity rationale, and the specific case elements most likely to be dispositive during the discussion.

Equally important, the platform helps physicians identify the “critical phrasing” and policy-linked rationale that medical directors often need in order to approve the case. Support staff can easily generate these documents and email them to physicians so they can view the rationale on their phones before P2Ps — effectively putting the rationale in their pockets, which eliminates the look-up hassle and review burden many providers face, giving you happier doctors.

The result is reduced preparation burden, fewer frustrating and inefficient P2P interactions, and improved approval outcomes.