P2P Intelligence

Win more appeals, with less friction.

Don’t send physician advisors into peer-to-peer calls unprepared. Generate clear, criteria-backed talking points tailored to the specific payer policy.

Talk It Through

Example talking points

Patient met acute inpatient criteria based on persistent tachycardia failing outpatient management.
IV antibiotics required intensive monitoring not feasible in an observation setting.

How it works

When an admission is denied, time matters. Instead of a physician advisor digging through hundreds of pages of records, the exact clinical markers needed to overturn the denial get surfaced directly.

1

PHI scrubbing and synthesis

The chart is ingested via FHIR and HIPAA identifiers are scrubbed before any computational analysis — zero external PHI exposure.

2

Criteria mapping

The clinical data is evaluated against payer-specific medical necessity guidelines.

3

Executive summary

Advisors get a short, actionable summary to reference during the scheduled peer-to-peer call.

Built for speed

Designed to be read quickly on a second monitor while the advisor is actively on the phone with the payer’s medical director — clean, high-contrast, focused on defensibility.

Manual chart reviewTime-consuming
Automated synthesisInstant