Win More Appeals.
With Less Friction.
Don't let your Physician Advisors go into Peer-to-Peer calls unprepared. We automatically generate clear, criteria-backed talking points tailored to specific payer policies.
Request a DemoMedical Necessity
Extracted from EHR
Patient met acute inpatient criteria based on persistent tachycardia (120 bpm) failing outpatient management.
Intravenous antibiotics initiated required intense clinical monitoring not feasible in observation setting.
How It Works
When an admission is denied, time is of the essence. Instead of your Physician Advisors spending 45 minutes digging through hundreds of pages of hospital records to find justification, Signal Core's engine surfaces the exact clinical markers needed to overturn the denial while maintaining strict, zero-trust PHI scrubbing compliance.
- 1
PHI Scrubbing & Synthesis
We ingest the patient chart via FHIR and instantly scrub all HIPAA identifiers before computational analysis, ensuring zero external PHI exposure.
- 2
Criteria Mapping
The clinical engine evaluates the clinical data specifically against heavily guarded payer rules like InterQual and Milliman.
- 3
Executive Summary
Advisors receive a punchy, actionable bulleted summary to read off during the scheduled peer-to-peer call.
Built For Speed
Our interface is designed to be read quickly on a separate monitor while the Advisor is actively on the phone with the Medical Director of the payer. It's clean, high-contrast, and deeply focused on defensibility.