Your payer policies. Ready to run.
Turn payer requirements into checks your software can run. Give your team clear findings and source references—inside your workflow, on your infrastructure.
- Catch documentation gaps earlier.See what needs attention before the next step.
- Give every team the same policy answer.Consistent checks against a specific policy version.
- Run it where you need it.Download this pearl and run it in your browser, even offline—with no per-check API fee.
See a payer policy in action.
This example checks a fictional TMS case against a BCBSMA policy snapshot. Change a fact to see the finding change—and the policy requirement behind it.
Fictional cases · Reviewer-supplied facts · Documentation support, not authorization. Scope and source
Case facts
Edit any answer. Findings update immediately. Open a section to review the supplied facts.
The current facts sent to the pearl. Change them in Case facts or choose another example.
What needs attention
Evaluation details
- Evaluator
- WebAssembly, on this device
- Decision requests to a server
- None · connections disabled
- Artifact fingerprint
- Checking…
- Matched-rule bitmask
- —
Documentation support only. Clinical review, member benefits, prior authorization, and payer approval remain separate.
Why this case needs review
See the policy requirements behind the findings, with a link to the source.
Scope and source
Demonstration, not authorization. Applies the represented commercial criteria to reviewer-supplied facts. Clinical judgments, member benefits and payer approval remain with the responsible parties. Source reviewed May 2026; retrieved September 20, 2026. Read the source policy
This pearl does not verify benefits, adjudicate claims, submit authorization requests, evaluate Medicare/FEP rules, or update its policy automatically. Clinical assertions remain the reviewer’s responsibility.
Take the rules with you.
Download this policy snapshot as a working HTML file. Open it in your browser and check cases offline. Future policy updates are separate.
Which payer policy slows your team down?
Bring us a policy your team checks repeatedly. Let’s look at the questions it needs to answer and where those checks belong in your workflow.