Catch the gaps before the payer does
Upload the documentation package and Paveo grades it against that payer's policy — which criteria are met, what's missing, and the denial risk — so you fix gaps before you submit, not after a denial.
Example output
IllustrativeReadiness verdict
Ready to submit
Denial risk
LowRequirements found
4- Diagnosis of moderately-to-severely active RA
- 3-month methotrexate trial at maximal dose, inadequate response
- No combination with another targeted immunomodulator
- Prescribed by a rheumatologist
Missing requirements
0Nothing missing — every policy criterion is supported.
Insurance context: payer-level review. Plan-specific requirements were not independently verified and may vary.
What you get
Every output, grounded in policy
Structured, reviewable, and traceable — never a black-box answer.
Readiness verdict
A clear ready / needs-review / not-ready call on the case as it stands.
Missing documentation
The specific records the policy requires that aren't in the packet yet.
Required evidence
Which policy criteria are already supported by the uploaded documents.
Payer criteria validation
Each criterion checked line-by-line against that payer's policy.
Denial risk
A High / Medium / Low band from the real met-vs-missing picture — no fabricated score.
Recommended next actions
Concrete steps to close each gap before submission.
Cover sheet
The case summarised for the reviewer — fields left blank and flagged where the notes don't support them.
Drafted letter of medical necessity
Editable, on your letterhead, with every clinical claim traced to your uploaded notes. Paveo prepares it; your team reviews and files it.
The check that belongs before submission
Most denials aren't clinical failures — they're preparation failures. Submission Readiness is the QA pass that turns a likely denial into a clean first-pass approval.
Know what's missing before you submit
Help your team reduce avoidable denials and accelerate therapy initiation.