PayerPolicy Watch
Payer coverage policies.
The day they change.
Commercial carrier policies, CMS NCDs/LCDs, and all 50 state Medicaid PDLs — automatically monitored. Every change logged with the effective date and the prior version. Primary-source. Not a summary of a summary.
Free tier available — no card required.
What PayerPolicy Watch covers
Commercial carriers
Aetna, Cigna, UnitedHealth, BCBS, Humana — coverage policies, prior auth criteria, formulary tiers, step therapy requirements.
Medicare (CMS)
National Coverage Determinations (NCDs) and Local Coverage Determinations (LCDs). Every revision logged with the LCD/NCD ID.
Medicaid (all 50 states)
State preferred drug lists (PDLs). Drug tier, UM requirements, and PDL update cadence tracked per state.
Change history
Not just current policy — what it said before, and when it changed. The signal that matters to denial management.
Who uses PayerPolicy Watch
Revenue Cycle Directors
Track PA criteria changes before denial rates spike. Know what Aetna changed last week before your billing staff figures it out from rejections.
Pharmacy Directors
Monitor formulary changes across commercial payers and Medicaid. Catch tier moves and new UM requirements before they affect dispensing.
RCM Vendors
API access to keep claim-scrubbing and PA rules current. Carrier-level data delivered to your workflow — not a once-a-quarter export.
Recent policy changes
Live data from the PayerPolicy Watch pipeline. Methodology →
Pipeline not yet live — sample data will appear here at launch.
Pricing
Free
$0
Policy directory. Current coverage status per payer and procedure. No change history.
Browse policies →Individual
$299/year
Full access — change history, PA criteria detail, email alerts on tracked policies. Up to 20 policy tracks.
Start free trialEnterprise
$25K–$75K ACV
Full system license. Dedicated onboarding. API. Custom alerting. RCM vendor embed available.
Request demoHow PayerPolicy Watch works
We fetch carrier coverage policies, CMS NCD/LCD files, and state Medicaid PDLs on a rolling basis. Every document is parsed against a canonical policy schema. When the content of a policy changes, we log the change with the prior version, the new version, and the effective date. No summaries — the underlying source document is always linked.
Read the full methodology →