Accepted Insurance Plans
- Medicare
- Medicaid
- BCBS PPO
- Aetna
- United Healthcare
Editable-looking rules
These rules are placeholders for the demo. They do not save permanently yet.
Not Accepted Insurance Plans
- Plan X
- Plan Z
- Expired or unverifiable coverage
Supported Equipment Categories
- Mobility equipment
- Respiratory equipment
- Hospital beds
- Walkers
- Cash-pay equipment
Required Documents by Equipment Type
- Signed prescription
- Chart notes
- Insurance card
- Face-to-face evaluation when applicable
- Prior authorization when applicable
Common Denial Reasons
- Insurance not accepted
- Equipment not covered
- Missing medical necessity documentation
- Low OCR confidence
Priority Referral Sources
- Hospital discharge teams
- Oxygen equipment referrals
- Complex mobility referrals
Example triage rules
- If insurance is not accepted, status = Likely Not Fillable.
- If signed prescription is missing, status = Needs Human Review.
- If accepted insurance + supported equipment + required docs present, status = Ready to Fill.