GUIDE
Execute multiple workflows from one evidence base
Operate from one source of truth. Clinical and coding experts evaluate new evidence and write it into structured policy that your systems can read and execute. The same policy can be referenced across workflows and stakeholders, with rationale and sourcing traveling with it.
The Payment Integrity Shift
From static PDFs to decision logic
New diagnostics, specialty therapies, and evolving treatment pathways arrive faster than legacy policy can absorb them. Today, policy sits in static documents, interpreted, implemented, and maintained separately across payment integrity and other policy-driven workflows. Lyric's clinical and coding experts translate new evidence into structured, actionable policy that you adopt as written or modify to fit your plan.
WHAT LYRIC DELIVERS
Lyric translates clinical and reimbursement evidence into structured, actionable policy. Adopt it as written or modify it, then run it across payment integrity and other key workflows. Clinical and coding experts maintain the policy as evidence changes. Teams, systems, and vendors can work from the same foundation. Answers trace to the policy behind them.
Guide Solutions
One platform. One evidence base. Multiple workflows
Emerging Evidence Structured Policy
Consistent Answers
Track the Evidence as It Evolves
Clinical experts review and operationalize emerging evidence across genetics, precision medicine, specialty therapies, infectious disease management, advanced imaging, and other high complexity areas.
One Evidence Base, One Source of Truth
Clinical policies can serve as a common source of truth for multiple decision points. Teams work from a shared foundation that supports consistency, transparency, and confidence across the decision-making process.
Written to be Executed
Clinical guidance is transformed into structured content that can be deployed across workflows, systems, and decision-support tools to reduce administrative burden and improve scalability.
Show the Evidence Behind It
Clear rationale, supporting evidence, and transparent decision criteria reduce ambiguity, resulting in a traceable and consistent foundation that supports operational efficiency and provider confidence.
Complex Reimbursement Clarity and Consistency One Source of Truth
Turn Complexity into Actionable Policy
Increasingly complex coding requirements and reimbursement methodologies are translated into clear standards for consistent payment decisions.
Align Coding, Coverage, and Payment
Reimbursement policies create a unified framework across claims editing, clinical reviews, and provider communications, supporting consistency and accuracy.
Single Source of Truth for Decisions
Structured reimbursement policies give systems, teams, and vendors the same source to work from, reducing conflicting interpretations and administrative friction.
Fewer Disputes. Less Rework
Transparent coding and payment guidance can be applied consistently, supporting a more predictable experience for health plans and providers.
the lyric difference
One Evidence Base
Multiple Workflows
Consistent Answers
- Clinical and Reimbursement Expertise: Integrated clinical and reimbursement policy creates one evidence base to help your team make consistent decisions.
- Structured Policy: Policy arrives in a format your systems can read and execute, not a document someone has to interpret first, so it can power editing, review, and automation.
- Built for Emerging Complexity: Continuously evolving content covers genetics, specialty therapies, infectious disease, laboratory testing, and advanced imaging.
- One Policy Set, Many Applications: One evidence base supports payment integrity, clinical review, provider engagement, and other policy-driven workflows.
- Transparency by Design: Clear rationale, evidence, and decision logic improve consistency and reduce ambiguity.
- Continuously Maintained and Governed: Clinical, coding, and reimbursement experts monitor, update, and refine policies as the evidence changes.
HEALTHCARE DECISION INTELLIGENCE FOR CLINICAL & Reimbursement POLICY
Multiple signals on every claim
One reconciled recommendation
Guide policies run on Lyric42. Multiple workflows read the same evidence base, and recommendations reconcile against your configuration.
Frequently Asked Questions
Guide is Lyric's clinical and reimbursement policy solution. Clinical and coding experts author clinical and payment policy as actionable policy content, and that policy can run across your payment integrity program as well as other cost-of-care workflows. Policies are grounded in expertise and scientific rigor, then structured as transparent, traceable rationale that supports consistent decisions.
Structured clinical policy is clinical evidence and criteria written in a format your systems can execute, rather than as a document a person interprets. A clinical policy document tells a reviewer what the evidence supports. Structured clinical policy tells a system, in a form it can apply without a translation step.
Traditional policy subscriptions provide documents. Lyric Guide delivers actionable policy guidance that can be applied consistently across payment integrity and other policy-driven workflows, maintained once and available to the teams and systems that need it.
Lyric Guide can serve as a single source of truth for clinical and reimbursement policy. The same policy can support payment integrity and other policy-driven workflows.
Lyric authors, maintains, and updates evidence-based clinical and reimbursement policies. You decide whether to adopt a policy as written or modify it, and how to apply it in your own workflows. Lyric monitors clinical guidance, coding changes, and regulatory updates to keep policy content current.
