Understanding medical, pharmaceutical and laboratory testing policy is at the heart of making sure patient claims are successful. Ensuring the patient meets eligibility criteria, submitting the correct documentation and adherence to coding requirements all ensure an effective claim. That is why we have designed tools to help you do your job more effectively, and reduce claim denials.
Policy Reporter hosts a vast database of live Payer Policies, including medical and pharmaceutical policies, reimbursement policies, criteria, PA forms, coding guidelines, provider manuals, fee schedules and more.
Find the Payer policy documents you need fast using our interactive dashboard. Search by document type, therapy category, Payer, state and plan type, to find the desired document(s). We offer a link to that exact document so that you can review the material for yourself.
What’s more, we’ll let you know at a glance when a given document was last updated.
Our universal search function allows you to search down to the most granular level within our centralized database hosting both Historical & Live policies to find the precise policy update you are looking for.
Whether you need access to a medical or reimbursement policy, a key prior authorization form or a pharmacy policy, Policy Reporter allows you to keep on top of the latest criteria documents with real-time access
Policy search can be refined by the following:
Our Fee Schedule tool simplifies the search for reimbursement requests and coverage by providing you access to a simple search supporting HCPCS or CPT codes.
Payers can have dozens of Fee Schedules that contain thousands of codes. Finding the right fee schedule can be a challenge while navigating the document can also prove time-consuming. Our Fee Schedule Tool simplifies the search for reimbursement requests and coverage by providing you access to fee schedules in a centralized location.
With the Fee Schedule tool, you can quickly find the supporting documents simply by looking up:
Reimbursement rates can vary based on a number of criteria, such as whether a procedure is carried out at an approved facility or not, so we provide a graph visualization that indicates at-a-glance the minimum, median and maximum rates and the number of rates at that level.
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