A prior authorization request is checked against a published Medicare coverage policy: the policy
becomes a tree of individual criteria, a clinical note is turned into structured facts, and the two
are compared to produce a verdict with the exact clause behind it.
This is a demo, built on 20 synthetic cases and 8 real policies, not a certified clinical tool.
Want to run it on your own note? Scroll down to Live mode and try it
with your own OpenRouter key.
Criteria tree
The policy's own published rules, laid out as a tree. Colour shows whether this case meets each one: green met, red failed, amber not documented.
Select a node to see the clause it came from.
Note & facts
The clinical note on the left, and the facts pulled from it on the right. Each fact is tied to the exact sentence it came from.
Verdict
The tree's bottom line for this case: approve, deny, or indeterminate, plus the one rule blocking approval.