DataQorp is OpAgent's proprietary policy intelligence engine — 3,439 prior authorization workflows, 28 payor families, and 5 policy layers. Built for orthopedic surgery and interventional pain management. Updated continuously.
DataQorp doesn't index generic insurance guides. It maps the exact clinical criteria, documentation requirements, and medical necessity thresholds that determine approval or denial at each payor.
Office of Inspector General rules governing documentation integrity, coding accuracy, and medical necessity language. Applied to every note regardless of payor. Flags documentation gaps that could attract OIG scrutiny — so you can fix them before submission.
Local Coverage Determinations from Medicare Administrative Contractors. Includes SI joint fusion, spinal cord stimulation, epidural injections, and 80+ musculoskeletal procedures with full indications, limitations, and documentation thresholds.
Payor-specific prior authorization criteria mapped to procedure and workflow. Cigna EviCore, UHC, Aetna, BCBS plans, Regence, Premera, Molina, Centene and 20 more — each with required documentation, imaging criteria, conservative care thresholds.
National Coverage Determinations from CMS — the federal baseline that all Medicare payors must follow. Includes implantable neurostimulators, lumbar artificial disc, vertebral augmentation, and other nationally adjudicated procedures.
Medicare Administrative Contractor billing and coding articles that supplement LCDs. Modifier guidance, ICD-10 code specificity requirements, and billing limitations that determine whether a claim is processed or returned for additional documentation.
Procedure-specific clinical criteria from NASS, ISASS, ISIS, and ASIPP guidelines that payors reference in their medical policies. Knowing what the society guidelines require means your documentation speaks the same language as the coverage criteria.
Each bubble represents a payor family in the DataQorp engine. Size reflects workflow depth. Hover to explore coverage. Every bubble is a live data source powering Admin Qo-Pilot authorizations in real time.
| # | Payor Family | PA Workflows | Coverage Depth | Type |
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DataQorp doesn't store generic insurance summaries. It maps the exact clinical criteria — procedure by procedure, payor by payor — that determine whether a prior authorization is approved or denied. This is what OpAgent's agents run on.
Admin Qo-Pilot runs on DataQorp intelligence. Every major payor. Every spine and pain procedure. Built for your practice.
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