Medical Policy Intelligence
Find the policy. Understand the criteria. See what changed.
AI-powered Medical Policy Intelligence for Pharma and MedTech teams.
Search and analyze thousands of US payer policies, compare coverage criteria, explore historical versions, and turn fragmented policy information into decision-ready insights.
The problem
Stop searching payer websites one policy at a time.
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Find the payer website.
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Search for the intervention.
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Open the PDF. Find the relevant section.
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Check whether the policy is current.
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Compare it with another payer.
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Copy the findings into a spreadsheet.
Then repeat.
Market4Health brings payer policies into one continuously updated, AI-powered intelligence platform.
Ask the question. Find the policy. Get to the insight faster.
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Search medical policies with AI
Market4Health’s AI engine analyzes document content and dozens of document attributes to help you find policies relevant to a specific treatment, intervention, condition, or therapeutic area.
Search using natural language. The AI engine interprets questions in human language and identifies relevant information based on the underlying policy content.
Find the information inside the document — not just the document title.
Ask questions like:
Search by:
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Navigate a structured medical policy catalog
Not every payer document is a medical policy.
Market4Health uses data-science models to distinguish medicine-specific content from general administrative policies with 96% precision. Relevant policies are further classified by therapeutic area and type of health intervention with 84%+ overall accuracy.
Move from a mass of payer documentation to a structured policy landscape.
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Identify conditions with medical context
Market4Health identifies diseases and conditions present within policy content and maps them to ICD-11. Results are verified by medical experts.
Instead of relying only on exact terminology used in a policy, teams can identify medically relevant content across complex documents.
Find the condition. Understand the policy context. Trace it to the source.
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Understand the policy before reading every page
Market4Health generates summaries of individual policies, helping teams quickly understand the document scope, coverage position, relevant conditions, and key policy context.
Use the summary to determine where expert review is needed. Then access the original policy for deeper analysis.
Review faster without losing sight of the source.
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Explore policy history
Market4Health preserves historical policy data so teams can trace how payer documentation evolves over time.
Review previous document versions. Understand when updates were introduced. Explore policy history across more than two years of document changes. Identify areas requiring further analysis.
See the policy landscape as it changes — not as a static snapshot.
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Turn policy research into shareable intelligence
Less manual policy research. More time for Market Access strategy.
Teams working with payer policy every day
Teams researching payer coverage landscapes.