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Streamline Prior Authorization Documentation

The PA Document Finder is designed to simplify the prior authorization process for oncology treatments. By providing quick access to documentation requirements organized by cancer types, subtypes, stages, and treatment phases, this tool helps reduce delays in patient care and improve authorization success rates.

Key Benefits

  • Comprehensive Cancer Coverage

    Get documentation requirements for 6 major cancer types: Breast, Cervical, Colorectal, Lung, Skin, and Uterine cancers.

  • Subtype-Specific Requirements

    Detailed requirements tailored to specific cancer subtypes with intelligent filtering based on your selections.

  • Stage-Aware Documentation

    Documentation requirements organized by cancer staging (Stage 0-4) with subtype-specific stage availability.

  • Phase-Based Organization

    Clear organization by treatment phases: Neoadjuvant, Adjuvant, and Maintenance therapy requirements.

  • Radiation Therapy Integration

    Specialized documentation for treatments that include radiation therapy components.

  • Intelligent Workflow

    Five-step selection process with dynamic filtering to quickly find the exact documentation needed for any treatment scenario.

How to Use the Pathway Document Finder

Follow this 5-step process to quickly find the exact documentation requirements for your patient's treatment pathway.

Step 1: Cancer Type Selection

Breast Cancer

Comprehensive coverage including DCIS, Inflammatory, and Invasive subtypes.

Lung Cancer

Documentation for NSCLC, SCLC, and Adenocarcinoma subtypes.

Cervical

Requirements for Adenocarcinoma, Adenosquamous, and Squamous Cell subtypes.

Colorectal

Coverage for polyps with invasive cancer and metastatic disease.

Skin

Requirements for Melanoma (Cutaneous/Uveal), Basal Cell, and Squamous Cell.

Uterine

Documentation for Endometrial and Uterine Sarcoma subtypes.

Step 2: Cancer Subtype Selection

Once you select a cancer type, the system automatically filters available subtypes. Each cancer type has specific subtypes with tailored documentation requirements.

Breast Cancer

DCIS, Inflammatory, Invasive

Lung Cancer

Adenocarcinoma, Non-Small Cell (NSCLC), Small Cell (SCLC)

Cervical

Adenocarcinoma, Adenosquamous Carcinoma, Squamous Cell

Colorectal

Polyps with invasive cancer, with/without distant metastases

Skin

Basal Cell, Melanoma: Cutaneous, Melanoma: Uveal, Squamous Cell

Uterine

Endometrial, Uterine Sarcoma

Step 3: Stage Selection

Select the cancer stage. The system intelligently filters available stages based on your subtype selection. For example, DCIS only shows Stage 0, while Inflammatory breast cancer shows Stage 3 and 4.

Stage 0

In situ cancers (like DCIS) - cancer cells are only in the layer of cells where they started.

Stage 1-2

Early-stage cancers - small tumors that haven't spread to lymph nodes or nearby tissues.

Stage 3

Locally advanced cancers - larger tumors that may have spread to lymph nodes.

Stage 4

Metastatic cancers - cancer has spread to other parts of the body.

Step 4: Treatment Phase Selection

Choose the treatment phase. Available phases may be restricted based on your subtype and stage combination. For example, DCIS Stage 0 excludes Neoadjuvant therapy.

Neoadjuvant

Pre-surgical treatment to shrink tumors and improve surgical outcomes.

Adjuvant

Post-surgical treatment to eliminate remaining cancer cells and prevent recurrence.

Maintenance

Long-term therapy to maintain remission and monitor for recurrence.

Step 5: Radiation Therapy Option

Indicate if radiation therapy is part of the treatment plan. This selection may show additional or modified documentation requirements specific to radiation treatments.

Radiation Therapy

Additional documentation requirements for treatments involving radiation therapy planning and delivery.

Best Practices for Documentation

  • Accurate Cancer Classification

    Start with the correct primary cancer type to ensure appropriate subtype and stage options are available.

  • Subtype and Stage Verification

    Ensure accurate subtype and stage classification through proper testing, imaging, and pathology review.

  • Stage-Specific Restrictions

    Be aware that some subtypes have restricted stage options (e.g., DCIS is only Stage 0, Inflammatory breast cancer is Stage 3-4).

  • Phase-Specific Planning

    Review documentation requirements for each treatment phase, noting that some combinations exclude certain phases (e.g., DCIS excludes Neoadjuvant).

  • Radiation Therapy Considerations

    When radiation therapy is planned, select this option to see additional documentation requirements specific to radiation treatments.

  • Sequential Documentation

    Follow the treatment timeline and ensure previous phase documentation is complete before proceeding to the next phase.

  • Current Protocol Verification

    Always verify documentation requirements with your local team and current treatment protocols before final submission.