Coverage Operations Platform
Make coverage workflows predictable
Caduce helps providers and patients move prior authorization, medical-necessity letters, intake, and follow-up through one shared workflow. Generate stronger submissions, keep case details organized, and stay aligned on what happens next.
Dear Medical Director,
I am writing to request coverage for the CardioMonitor Pro continuous cardiac monitoring device for the above-referenced patient.
The patient has been diagnosed with atrial fibrillation and needs continuous monitoring.
Clinical evidence demonstrates that remote cardiac monitoring is effective for these patients.
Sincerely,
Dr. Sarah Chen, MD
By the Numbers
The coverage problem is system-scale
The issue is not occasional friction. It is high-volume, high-cost, and regularly causes patients to fall out of care.
of physicians say prior authorization causes patients to abandon recommended treatment
AMA 2024 PA Physician Surveyestimated annual provider administrative cost of fighting claims denials
AHA payer denials analysis, published Apr 2024prior authorization determinations were made for Medicare Advantage enrollees in 2024
KFF analysis, published Jan 2026The Challenge
Coverage work breaks at the handoff
Prior auth is rarely blocked by a single form. Clinical documentation, patient intake, insurer requirements, and follow-up all live in different places, which slows teams down and leaves patients without clear next steps.
Fragmented case information
Insurance details, intake answers, supporting documents, and draft letters are scattered across inboxes, portals, and PDFs.
Manual documentation loops
Providers still rewrite letters and prior auth packets by hand, which slows submissions and creates avoidable errors.
No shared follow-through
After submission, patients and care teams often lose visibility into status, missing documents, and the next action needed.
How Caduce Works
Coverage operations in one place
Documentation built for submission
Draft letters of medical necessity, prior authorization requests, and appeal materials in one workspace instead of starting from scratch.
Coverage guidance before you send
Review payer requirements, missing evidence, and likely review risks before the packet goes out.
Shared tracking across the case
Keep providers and patients aligned on intake, uploaded documents, status changes, and next steps after submission.