PayerPolicy Watch

What it is

PayerPolicy Watch is the first paid product on the largest prospect base: every hospital RCM, every physician group billing team, every pharma market-access team, and every CRO that needs to know when payer rules change. Today the work is done by hand — staff scan portals on Mondays and compile a Google Sheet of what changed.

The product is one feed. Each captured change carries the source document, the effective date, the diff against the prior version, and a plain-English translation into the operational response. A subscriber sets a watch on the codes, payers, and states that matter to their book and receives a daily digest with two sections: changes effective in the next 60 days (plan for them) and changes effective immediately (workflow response now).

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Primary data sources

• Commercial payer medical policy portals — Aetna, Anthem/Elevance, Cigna, UnitedHealthcare, Humana, BCBS plans — policy documents, PA requirements, fee schedule notes
• State Medicaid program publications — Coverage policy, fee schedule, and bulletin changes by state
• CMS National Coverage Determinations + LCDs — Medicare coverage policy baseline
• Payer provider manuals — Administrative requirements, claims edit rules

Buyers

• Hospital revenue cycle and managed care contracting
• Physician group billing leadership
• Pharma market access teams (commercial + government)
• Specialty pharmacy operations
• Population health and ACO contracting

Methodology

Every captured document is diffed against the prior version and stored. Operational translations are templated and reviewed; the source link and effective date are always present.