⚡ BCBSIL/Carelon Oncology PA Requirements Changed April 1, 2026 — Illinois practices submitting under old codes are receiving denials. ClearPath has mapped every change. Protect Your Practice →

Services How It Works Compliance Results Start Your Pilot →

Oncology Prior Authorization Specialists

Your Oncology PA Team Is Generating Denials You Don't Know About.

ClearPath's Error Prevention Engine catches documentation failures before submission — so your approvals come back faster and your revenue stops disappearing.

General BPOs submit. ClearPath verifies. Our credentialed RN specialists run every case through a 4-layer documentation review before it ever reaches the payer — catching the mismatches, missing clinical criteria, and code errors that generate preventable denials at competing services.

Request Your 30-Day Pilot → See How It Works ↓

🔒 HIPAA Compliant  ·  🎖️ Veteran-Owned SDVOSB  ·  No long-term contracts  ·  $2,000 pilot deposit credited in full

Live Case Dashboard

94.2%

First-Pass Approval Rate — Current Pilot

PA Submissions Today18
Avg. Turnaround31 hrs
Errors Caught Pre-Submit3
$15,400
Average revenue lost per denied oncology authorization
Chemotherapy, infusion, and specialty drug PAs fail at a rate 4× higher than general medical.
35%
Denial rate at general-purpose BPOs
vs. under 8% at oncology-specialized practices. The gap is documentation — not coverage.
72 hrs
Typical PA turnaround at understaffed practices
ClearPath standard: 24–48 hrs. Priority: 4–8 hrs. Stat: 2 hrs. Every case tracked in real time.

The ClearPath Difference

The Error Prevention Engine:
4 Layers Between Your Practice and a Denial.

Every case goes through our complete review protocol before it touches a payer. This is what prevents denials — not chasing them after the fact.

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Layer 1 — Payer Intelligence Scan

We cross-reference every case against our payer-specific documentation requirement database — updated in real time as payer policies change. What BCBSIL requires for bevacizumab differs from what Aetna requires. We know the difference.

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Layer 2 — Clinical Criteria Alignment

Our credentialed RN reviewers verify that submitted clinical documentation meets the payer's specific medical necessity criteria for that exact drug, dose, and diagnosis — before submission. Not after denial.

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Layer 3 — CPT/ICD-10 Code Validation

We validate CPT and ICD-10 code combinations against the payer's current fee schedule and NCCN guideline alignment. Code errors are the #1 source of preventable oncology denials. We eliminate them at the source.

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Layer 4 — Real-Time Submission Tracking

Every case gets a live dashboard status visible to your team from submission through decision. No black boxes. No "we're working on it." You see exactly where every PA stands, right now.

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Case Received
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🔍
Payer Scan
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📋
Clinical Review
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🧬
Code Validation
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📤
Submission
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Live Tracking
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✅
Approval

How It Works

From Case Submission to Approval — We Handle Everything.

Five steps. Full coverage. Real-time visibility at every stage.

1

📞 Discovery Call (30 min)

We learn your payer mix, EHR setup, volume, and current bottlenecks. No generic pitch — we document your specific workflow before we configure anything.

2

⚙️ EHR Integration

Our team handles setup — Epic, Cerner, athenahealth, or custom. No IT burden on your staff. Typically complete within 48 hours.

3

🚀 30-Day Pilot

50 cases, full service, side-by-side performance tracking. Your team sees every case in real time. No shadow workflows.

4

📊 ROI Report

At day 30 you receive a complete denial reduction and revenue recovery analysis. You see exactly what ClearPath returned vs. your current process.

5

✅ Your Decision

No sales pressure. No long-term commitment lock-in. If the numbers work for your practice, you continue. Your $2,000 deposit applies in full to month one.

Services

Three Engagement Levels. One Standard of Accuracy.

Start with PA support and expand as your confidence grows. Every tier includes the same RN-credentialed review standard.

Tier 1 — Standard

Prior Authorization & Payer Workflow Support

Priced per case — volume pricing available

  • Documentation completeness review before submission
  • Payer-specific requirement alignment
  • Submission support & real-time case tracking
  • Escalation preparation & follow-through
  • Turnaround: 24–48 hrs standard / 4–8 hrs priority / 2 hrs stat
  • Monthly performance reporting
Start With PA Support →
⭐ Most Popular

Tier 2 — Recommended

Clinical Documentation & Accuracy Support

Monthly retainer — custom to your practice volume

  • Everything in Tier 1, plus:
  • Completeness & consistency checks
  • Guideline-aligned documentation preparation
  • CPT/ICD-10 code validation
  • SDOH documentation gap identification
  • Error catch rate reporting
  • Dedicated Clinical Documentation Specialist
Request Documentation Support →

Tier 3 — Coming Soon

Healthcare Cybersecurity Advisory

Join waitlist for early access pricing

  • HIPAA Security Risk Assessment
  • Vulnerability Prioritization
  • Incident Response Planning
  • Staff Training Program
  • Fractional CISO Advisory
Join the Waitlist →

Proof of Performance

Practices Like Yours. Results You Can Benchmark Against.

ClearPath performance data from oncology practice pilots. Identifiable details generalized per BAA.

Mid-size infusion oncology, IL (18 providers)

First-pass approval rate
61%→ 91%
Monthly denials
47→ 8
PA turnaround
68 hrs→ 31 hrs

"We didn't realize how many denials were coming from documentation mismatches rather than coverage issues. ClearPath caught what our billing team couldn't."

✓ Pilot completed. Full service enrolled.

Solo oncologist — high Medicaid/BCBSIL mix

Denial overturn rate
44%→ 89%
Revenue recovery (month 1)
$12,400
PA staff hours redirected
22 hrs/wk freed

"The payer intelligence scan caught a BCBSIL code routing change we hadn't heard about. Two cases approved that would have been denied."

✓ Month 3 of ongoing service.

Oncology group — multi-payer, Epic EHR

Time to first approval
74 hrs→ 26 hrs
Error catch rate (pilot)
94.2%
Staff admin burden
Reduced 34%

"Epic integration was done in less than 48 hours. Our team didn't have to touch anything."

✓ Cybersecurity pilot scheduled.

Compliance

HIPAA-Compliant Operations — Not a Checkbox. An Architecture.

BAA EXECUTED U.S. DATA RESIDENCY ROLE-BASED ACCESS WORKFORCE TRAINING BREACH PROTOCOLS 🛡
🎖️ SDVOSB 🏢 Illinois LLC 🔒 HIPAA Compliant 📄 BAA Available 👩‍⚕️ RN-Credentialed Staff 🇺🇸 U.S. Data Residency
No. All PHI is stored on U.S.-based, HIPAA-compliant infrastructure. Our clinical team accesses data via encrypted remote session only. We provide a signed Data Residency Statement on request.
Yes. Every engagement begins with a fully executed BAA. Available for review before you sign anything.
Yes. All staff — regardless of location — operate under documented HIPAA training, role-based access controls, and are covered by our executed BAA and Business Associate Subcontractor Agreements.
Our incident response plan includes 60-day breach notification per HIPAA requirements, forensic documentation, and client notification. We maintain documented response protocols and conduct annual tabletop exercises.
Role-based access, MFA on all clinical systems, encrypted remote sessions, no local PHI storage, and audit logs available on request.

Low-Risk Entry Point

See What ClearPath Recovers in 30 Days.

50 cases. Full service. Real-time visibility. No long-term commitment.

50
PA Cases
30
Days
$2K
Deposit — Credited in Full

⚡ Your $2,000 pilot deposit applies in full to your first month of service if you continue. If not — no further obligation. We earn your business every 30 days.

No spam. No sales calls. A ClearPath specialist responds within 1 business day.

✅ Request Received!

A ClearPath specialist will reach out within 1 business day to schedule your discovery call. Check your email for a confirmation.