Every denial teaches a rule.
What each denial taught, waiting on a person to decide whether it becomes policy. Nothing here is live: every candidate is reviewed weekly, and a rule that is promoted applies to the next request for that payer.
Block override of an EL-class eligibility warning unless the actor holds the manager role.
Raised because coverage not active on service date on PA-2026-0087.
Require a signed patient balance consent before submitting above the remaining benefit.
Raised because benefit limit exceeded on PA-2026-0091.
Raise an amendment task the moment a service line is added after approval, before discharge closes the window.
Raised because service not covered by the pre-authorization on CL-2026-0414.
Route any unspecified diagnosis on an imaging line through a specificity review before submission.
Raised because diagnosis-procedure inconsistency or insufficient specificity on CL-2026-0417.