PayorProof checks a Scribe note against payor coverage policies, flags documentation gaps, and suggests cited edits.
After it has completed it's process, Users can accept or reject each item before it's applied to the note.
The system is designed to create the best possible outcome for the patient's treatment in any message sent to the Insurance service.
How it works:
- Start it. After a visit, with a completed note open, the clinician picks the PayorProof chip in the Scribe Ask panel ("Review payor policies, identify criteria, and suggest cited edits").
- Analysis. The AI identifies what needs coverage (e.g., a prescription or procedure). It then pulls the relevant payor policies and compares them against the note and transcript.
- Review inline. Suggested edits are highlighted in the note, each with Accept / Reject. A toolbar lets the clinician move between edits or Accept all.
- Fill in missing facts. If an edit needs information only the clinician has (e.g., "duration," "risk status"), an inline input appears. The clinician supplies the value, and it's never invented.
- Citations. Each edit links to the payor policy behind it: payor, quoted policy passage, and source URL.
Finish. Once every suggestion is resolved, the note updates automatically. From there the clinician can edit normally or run PayorProof again.
Feedback. Helpful / Not Helpful ratings are on completed PayorProof answers.
Core principle: Nothing changes in the note without the clinician's explicit approval, and every suggested change is grounded in a cited policy.