Medical Policy and Coverage Data

Search 1000s of plan medical coverage policies, benchmark your rules.

AI-based Search

Email Alerts

Search Policy ICDs and CPTs

Get Trend Analytics

Find similar payer forms

Rule Citations

Compare specific rules

Cost Management Impacts




GenHealth is working with health plans, providers, and pharma to provide more transparency and data about various rules and coverage policies. We use our own generative AI model built on patient histories to automate rule extraction from 1000s of medical policies across the industry.

 
 
 
 

Bechmark and compare your rules and policies against similar documents from competitive payers

Find similar payer forms

  • Assess the efficiency of comparable prior authorization processes.
  • Compare timeframes for decision-making, the ease of the process for providers and patients, and the clarity of their documentation.

Rule Citations

  • Identify the specific language from other plans used to generate prior auth rules.
  • Improve claim approval rates and reduce administrative burden by understanding the root causes of rules and denials.

Compare specific rules

  • Understand where your policies stand in comparison to competitors.
  • Identify areas where policies might be more restrictive or lenient than others, impacting market competitiveness.

Cost Management Impacts

  • Evaluating how your policies impact healthcare costs.
  • Understand the financial implications of your coverage decisions on both the health plan and the patients.



The most thorough search for prior auth forms and medical coverage policies, all powered by generative AI


AI-based Search

  • Streamline policy searches using advanced AI embeddings, ensuring quick and precise retrieval of information.
  • Enhance efficiency in navigating complex policy databases, leading to faster decision-making and improved policy management.

Email Alerts

  • Receive automatic notifications about updates, changes, or new additions to policies, keeping you informed in real time.
  • Stay ahead of policy shifts and ensure compliance with the latest healthcare regulations and standards through timely alerts.

Search Policy ICDs and CPTs

  • Easily locate and analyze policies based on specific ICD and CPT codes.
  • Facilitate accurate billing and reduce claim denials by aligning healthcare services with appropriate coverage policies.

Get Trend Analytics

  • Keep up with current trends in healthcare coverage and prior authorization.
  • Adopt best practices and innovative approaches used by other health plans.



Want to learn more?