Solutions, Health, Medical claims review

Necessity is a chart-read

Every UM and post-payment review is a re-read of records the system has already touched. Owl reads every page of the chart, walks MCG, InterQual and LCD criteria element by element, and tells you which bucket each line lands in (approve, deny, pend or refer), cited for member, provider and IRO.

Policy triggers, fires / doesn'tOne filed claim
Triggered
MCG / InterQual criteria fully met

KL grade 3 imaging, BMI 31.4, six months conservative care including NSAID + 14 PT visits + two IA-CS injections, surgeon in-network. Every element documented in the chart.

cite: MCG ORG: M-2052 v25, EHR PT log 2024-08 → 2025-02
Triggered
Site-of-service medical necessity

Inpatient site supported by anesthesia history (severe OSA, AHI 38) and prior post-op respiratory event documented in the discharge summary from 2023.

cite: Sleep study 2024-09, Discharge summary 2023-11
Not triggered
Step-therapy exhaustion

No CMS step-therapy required for this CPT under our medical policy. Pharmacy step requirements do not apply to surgical authorization.

cite: Med Policy 4.21 §3.b
Not triggered
Off-label / experimental flag

CPT 27447 is FDA-cleared and on the plan’s standard surgical inventory. No experimental override needed.

cite: Plan inventory 2025, FDA 510(k) clearance

Auto-approve

Drafted with MCG and EOC cites

11s, 1.4s

Full-chart read, answer time

$0

Cost of pending an approvable case

03A real claim, walked end to end

One PA: 312 pages, 11 seconds, four questions answered.

Anonymized composite. Member 64F, CPT 27447 (right TKA), submitted by an in-network ortho group with full chart attached.

Auth #
PA-2025-90412
Service
CPT 27447, TKA, R
Member
64F, MA, KL3
Site
Inpatient, 1 night
Determination
Auto-approve
OwlVision
What it read
PA request + ICD-10 / CPT
4 pp
Read, indexed, cited
EHR, last 18 months
312 pp
Read, problem-list mapped
Imaging reads (radiology)
22 pp
Read, DICOM-linked
PT visit log + outcomes
28 pp
Read, failure documented
MCG / InterQual criteria
8 pp
Read, criteria-walked
Structured extraction
Member 64F; CPT 27447 (TKA, R); ICD-10 M17.11; BMI 31.4; failed 6mo conservative care (NSAID + PT 14 visits + IA-CS x2); KL grade 3 imaging; surgeon in-network; OSA AHI 38 supports IP site.
OwlSignal
What the world said about the claimant

External data only. None of this lives in your CMS. Owl gathered it from public records, professional networks, registries and the open web, then resolved it to this claimant.

CRT-01
MCG criteria fully met, auto-approve cohort

MCG 27th ed. and InterQual SmartSheet for TKA both mark every required element met. Plan-cohort auto-approve rate on this CPT + member profile is 94%. Auto-approval is in-band for plan policy and CMS standards.

MCG ORG: M-2052 v25InterQual SmartSheet 2025Plan auto-approve cohort
IRO-04
IRO overturn risk if denied: 71%

Owl’s IRO database (n=180K independent-review decisions across 14 states) shows denial of TKA when MCG criteria are met is overturned at 71%. Denial would create CMS Star measure exposure and provider abrasion without medical-necessity basis.

Owl IRO corpus (180K decisions)CMS Stars: appeals timelinessState external review filings
PRV-02
Surgeon outlier, CMS Care Compare

CMS Care Compare + Hospital Compare show surgeon’s 30-day readmit at 11.4% (specialty peer 4.2%). Not denial-relevant; route to case-management for post-op outreach to mitigate readmit risk.

CMS Care CompareHospital ComparePlan readmit cohort
CMP-07
Pre-op clearance gap, external EHR

Datavant + Epic Care Everywhere pull surfaces a prior MI from 2022 not in the submitted chart. No cardiac clearance is documented for this surgery. Recommend pend for clearance, then approve: small delay, large risk reduction.

Datavant longitudinal recordEpic Care EverywhereAHA peri-op guidelines
OwlAssist
What it answered
Examiner asked
Is this TKA approvable today, and what is the determination language?
Owl answered in 1.4s

Yes, approvable. The member meets every MCG TKA criterion: KL grade 3 imaging, BMI under 35, six months of failed conservative care including NSAID, 14 PT visits and two IA-CS injections. Surgeon is in-network. The single open item is documented cardiac clearance given the prior MI surfaced from external EHR. Recommend approve with a note to the surgeon to obtain clearance before scheduling. Determination language with citations to MCG and the member EOC is drafted below.

MCG ORG: M-2052 v25EHR PT notes 2024-08 → 2025-02Imaging report 2025-02-14EOC §6.4
Examiner asked
If we denied this, what is our overturn exposure?
Owl answered in 0.9s

Substantial. Owl’s IRO corpus shows 71% overturn for denials on this fact pattern. Beyond the financial exposure, denial would harm the plan’s CMS Stars appeals-timeliness measure and create avoidable provider and member abrasion. There is no documented medical-necessity basis to deny.

Owl IRO corpus 2024–2025CMS Stars 2025 measure specPlan IRO history pp.12–18
04OwlSignal external data

What the world says about your Medical claims review claimants, none of which lives in your CMS.

Internal claim data is half the picture: it tells you what the claimant told you. OwlSignal continuously gathers external data (public records, professional and corporate registries, court dockets, social and open web) and matches it back to the claimant. These are the families that move the needle on Medical claims review.

CRTClinical Criteria Corpora

MCG, InterQual, Hayes, ECRI, NCCN, ACR Appropriateness: the criteria libraries that determine medical necessity. Walked element-by-element against the chart, with the version and edition cited on every decision.

MCG (Hearst)InterQual (Change Healthcare)Hayes Inc.ECRI, NCCN, ACR, UpToDate
IROExternal Review Decisions

Independent Review Organization (IRO) decisions from state DOIs and CMS: what gets overturned, what survives. Owl’s corpus is 180K decisions across 14 states, refreshed monthly.

State DOI external review filingsCMS external review dataOwl IRO corpus
PRVProvider Quality & Patterns

CMS Care Compare, Hospital Compare, Physician Compare, OIG LEIE, state license sanctions, Owl’s cross-payer utilization graph, to surface provider context the chart alone won’t reveal.

CMS Care Compare / Hospital ComparePhysician CompareOIG LEIE, SAM.govState medical board sanctions
CMPExternal Clinical History

Longitudinal medical history from outside your data, where the law and the member’s consent allow. Surfaces prior conditions, prior procedures, and prior failed therapies the submitted chart doesn’t include.

DatavantEpic Care EverywhereCommonWell + CarequalityeHealthExchange
POLPolicy & Plan Constructs

EOCs, medical policies, LCDs, NCDs, drug formularies and benefit grids. Read once, indexed forever, and re-walked on every determination so policy changes propagate immediately.

Plan EOC + medical policy libraryCMS NCD/LCD databasePlan formulary + tier files
OIGOIG Workplan + CERT Comparators

OIG annual Workplan, CERT national error-rate data and HHS PERM samples: the patterns that determine pay-and-chase exposure and FWA referral defensibility.

OIG annual WorkplanCMS CERT improper-payment dataHHS PERM samplesGAO healthcare reports
Refreshed daily, matched by identity-resolution, every observation cited to its source.
05What changes

Numbers from health plans running Owl on medical claims review in production.

MetricWithout OwlWith Owl
Charts read end-to-end38%100%
Time to determination6.4 days4 hours
Auto-approval rate, clean cases11%64%
Overturn rate at IRO38%12%
Avg cost per UM review$84$22
Member abrasion, CSAT delta+18 pts
Source: rolling 12-month average across 5 health plans, UM + post-payment review, n = 312,400 reviews.

Built for the regulatory shape of Medical claims review.

07Integrations

Lives where your Medical claims review files live.

Core admin

HealthEdge HealthRules, Cognizant Trizetto Facets, QNXT

UM platforms

GuidingCare, Aerial, MedHOK, ZeOmega Jiva

EHR / records

Epic, Cerner, Allscripts, MRO, Verisma, Datavant

Criteria libraries

MCG, InterQual, Hayes, ECRI, NCCN, ACR

Document intake

Box, OnBase, Documentum, ImageRight, faxes via SR-Fax

Identity & SSO

Okta, Azure AD, PingFederate, SAML, SCIM

08Get started

Bring us a week of UM reviews. We’ll show you the bucketing on day one.

Two-week pilot. Your charts, your tenant, your medical policy. We measure cycle time, auto-approval rate, IRO survival rate and reviewer hours saved against your own ground truth.