Medical Policy Interpreter

Transform complex medical insurance policies into clear, actionable information using Anthropic's Claude API. Our system analyzes policy codification—how well medical criteria translate into consistent coverage decisions—helping patients, providers, and insurers understand requirements and improve transparency. How it works: Upload your medical policy PDF → Claude AI analyzes policy language and codification quality → Receive structured insights including plain English summaries, clear requirements, areas needing interpretation, and opportunities for system improvement. Analysis Framework: We use this prompt with Claude 3 Opus: "Analyze this medical policy focusing on codification quality—how well medical criteria translate into consistent prior authorization decisions. Provide: Plain English Summary, Clear Requirements (well-codified criteria), Ambiguous Areas (requiring interpretation), Codification Assessment (how effectively policy enables consistent decisions), and System Improvement Opportunities (areas where clarity would benefit all stakeholders). Include policy text citations for each point."