AI-assisted PA processing and clinical documentation accuracy for oncology practices — handled by credentialed RN specialists. Your team sees every case in real time. We plug into your existing EHR. No shadow workflows.
Oncology prior authorizations are complex, time-sensitive, and denial-prone. Most practices are managing them with understaffed billing teams or general-purpose BPOs that don't understand chemotherapy protocols, payer-specific documentation requirements, or the true cost of a denied infusion.
A single denied chemotherapy authorization means delayed treatment, administrative rework, and lost revenue — sometimes exceeding $15,000 per case. The documentation gap between what payers require and what practices submit is where most denials originate.
ClearPath was built specifically for this problem. Not adapted from general healthcare BPO. Built from the ground up for oncology.
BCBSIL and Carelon changed oncology PA requirements effective April 1, 2026 — including the removal of radiation oncology codes previously reviewed by Carelon and updates to advanced imaging authorization. Practices submitting under old requirements are receiving denials. ClearPath has mapped all updated code requirements and payer routing changes to ensure zero treatment delays for Illinois oncology providers.
AI pre-screening catches missing documentation before submission. Fewer rejections on first pass. Faster turnaround — standard 24–48 hours, priority 4–8 hours, stat 2 hours.
Clinical documentation accuracy review identifies coding errors and payer requirement gaps before they become denials. Error prevention is built into every case we touch.
Every case reviewed by a credentialed oncology-trained RN. Not a billing clerk. Not an algorithm alone. Clinical expertise at every step of the authorization process.
Four steps. Full coverage. Real-time visibility at every stage.
Clinic submits PA case via EHR integration or secure portal. API, SFTP, or portal access — configured to your system.
AI engine is configured per payer — BCBSIL, Carelon, Medicare, Medicaid — and updated as payer requirements change. Flags missing documentation and denial risk before submission.
Credentialed RN specialist reviews, completes, and submits to payer. Appeals handled if needed. Nothing falls through the cracks.
Clinic receives real-time status updates and a 30-day performance report: approval rates, turnaround times, errors caught, denial reduction.
ClearPath Health Solutions is a healthcare-focused business process organization supporting complex, high-scrutiny clinical and administrative workflows. We work with organizations where accuracy, defensibility, and regulatory alignment are non-negotiable — particularly in oncology, specialty care, and payer-intensive environments.
We are not a generic outsourcing firm. We are a governed clinical operations partner.
To help healthcare organizations operate more effectively in increasingly complex reimbursement and documentation environments — without compromising clinical integrity, compliance, or patient trust.
ClearPath operates on a human-in-the-loop model designed for regulated healthcare environments. Automation supports our teams — it does not replace them. No autonomous clinical decisions are made. All clinically meaningful work is reviewed by trained personnel.
Our operating model emphasizes defined scope of use, role-based access controls, auditability, clear escalation pathways, and continuous review aligned with payer and regulatory change. Healthcare organizations need trustworthy processes — not more tools.
ClearPath Health Solutions is Service-Disabled Veteran-Owned (SDVOSB). We bring operational discipline, respect for regulated environments, and a bias toward responsibility over hype. Our clients trust us because we operate with the same seriousness they do.
ClearPath provides structured, human-supervised support across clinical and revenue-cycle-adjacent workflows where documentation accuracy and payer alignment are critical. Our services are designed to integrate with — not disrupt — existing teams.
We support organizations navigating complex prior authorization environments, particularly in specialties with evolving and evidence-driven payer requirements. All work is conducted within governed processes designed for defensibility.
Priced per case. Volume pricing available.
Start With PA SupportBeyond the authorization: Clinical Integrity. We assist with documentation quality and consistency to reduce preventable denials and rework. In underserved communities, a denial isn't just a delay — it's often a lost patient. We don't just submit. We advocate. Clinical interpretation is always reviewed by qualified personnel.
Monthly retainer. Custom to your practice volume.
Request Clinical Documentation SupportOncology practices are high-value targets for ransomware and data theft. Most have no assessment, no response plan, no documentation. ClearPath Cybersecurity Advisory fills that gap with healthcare-specific expertise built for the oncology practice market.
$2,000 deposit — credited in full to your first month if you continue. No credit card required until you say go. No long-term commitment.
Request Your Pilot Assessment →ClearPath is designed from the ground up for protected health information. Here is exactly how we protect your patients and your practice.
Every client engagement begins with a fully executed BAA covering data handling, transmission, breach notification, and subcontractor obligations. Available for review before signing.
All PHI is stored on U.S.-based, HIPAA-compliant infrastructure. PHI never physically leaves the United States. Our clinical operations team accesses data via encrypted remote session only.
All ClearPath staff receive HIPAA training at onboarding and annually thereafter. Access to PHI is role-based — each team member sees only what their function requires.
Small oncology practices are the fastest-growing target for healthcare cyberattacks. Most have no plan. We are building one specifically for you.
Documented HIPAA Security Rule risk assessment identifying your vulnerabilities, gaps, and priorities. Audit-ready output your compliance officer can rely on.
A written, tested incident response plan so your practice knows exactly what to do if a breach occurs — before it happens, not during the crisis.
Ongoing cybersecurity guidance from a healthcare-specialized advisor. The expertise of a Chief Information Security Officer without the full-time cost.
Waitlist members receive priority onboarding, founding-client pricing, and direct input into service design.
No spam. No obligation. Early access only.
50 PA cases. 30 days. $2,000 deposit credited in full to your first month if you continue. No long-term commitment.