01
Policy sprawl
Thousands of rules. Dozens of formats. Constant change.Coverage logic is fragmented across teams, documents, and systems.
POLICY INTELLIGENCE INFRASTRUCTURE
Turn health plan policy into executable intelligence.
Frontier Stack transforms medical policies, benefit rules, and utilization-management criteria into structured, auditable intelligence that powers payer operations.
Built for health plans, clinical operations, and utilization management teams.
MEDICAL POLICYLumbar Spinal Fusion
LIVESOURCE
Medical Policy 6.01.502Effective: July 1, 2026
CLINICAL CRITERIA
- ✓ Conservative therapy completed
- ✓ Imaging supports instability
- ○ Neurological deficit documented
DOCUMENTATION
MRI report · Treatment history · Specialist evaluation
ACTIONPrior authorization requiredHuman review if criterion 3 is ambiguous
Source linkedMP–2031 / v4.2
PDF → POLICY GRAPH
Built for teams responsible for millions of coverage decisions.
Medicare AdvantageMedicaidCommercial Health PlansUtilization ManagementClinical Operations
THE PROBLEM
Your policies were written for people. Your systems need them structured.
Thousands of coverage rules live across PDFs, benefit documents, clinical criteria, spreadsheets, and legacy systems. Every downstream workflow depends on interpreting them correctly.
02
Manual interpretation
Clinical expertise gets consumed by administrative work.Teams repeatedly interpret the same policy instead of focusing on exceptions.
03
Brittle systems
One policy change touches multiple downstream workflows.Small policy changes become large operational projects.
04
Limited explainability
Automation without provenance creates risk.Every recommendation must trace to the exact policy and effective date.
THE FRONTIER STACK
One intelligence layer.
Every policy workflow.
Not another workflow application. The governed intelligence infrastructure beneath all of them.
01 / SOURCES
Medical PoliciesBenefit DocumentsClinical GuidelinesGovernment RulesPlan RulesHistorical Decisions
FRONTIERIntelligence Graph
SYSTEM ACTIVEPolicyProcedureBenefitCodeCriterionEvidenceExceptionDecision
03 / OPERATIONAL APPLICATIONS
Prior AuthorizationAppealsClaimsProvider OperationsMember ServiceCompliance
POLICY INTELLIGENCE
From policy document
to operational logic.
COVERAGE GUIDELINES
Lumbar Spinal Fusion
Lumbar fusion is considered medically necessary when all of the following criteria are met:
Radiographic evidence demonstrates instability, and conservative therapy has been completed for a minimum of six weeks.
Requests must include a specialist evaluation and current imaging documentation.
12 / 24
EXTRACT→
PROCEDURELumbar fusionREQUIREMENTPrior authorization
CRITERIA
01Radiographic evidenceSatisfied
02Conservative treatmentSatisfied
03Specialist evaluationReview
SOURCEMedical Policy MP-2031
VERSIONEffective 07/01/2026
OPERATIONAL INTELLIGENCE
01 / POLICY ENGINE
Build a machine-readable layer over your medical policies.
Automatically structure criteria, documentation requirements, dependencies, and policy versions.
Explore Policy EnginePOLICY
→
CriteriaEvidenceCodeDecision
02 / PRIOR AUTHORIZATION
Put the right cases in front of the right reviewer.
Surface relevant policy criteria, missing evidence, satisfied requirements, and source-backed recommendations.
Explore Prior AuthorizationSUBMISSION RECEIVEDCASE #80921
8 criteria evaluated6 Satisfied1 Missing1 Clinical judgment
HUMAN REVIEW
Ambiguity surfaced—not hidden.
03 / APPEALS INTELLIGENCE
Reconstruct every decision in context.
Assemble the applicable policy, clinical evidence, previous decision, policy version, and appeal rationale.
Explore Appeals01Original request
02Determination
03Policy version
04New evidence
05Appeal
04 / REGULATORY INTELLIGENCE
Understand what changed—and everything it affects.
When a policy or regulatory source changes, identify affected rules and downstream workflows.
Explore Regulatory IntelligenceCMS REQUIREMENT UPDATED
Coverage guidance · NCD 150.3
7Policies affected
→21Rules affected
→3Workflows affected
POLICY DESK
Policy questions, answered.
Find the applicable requirement and trace it directly to the governing source.
POLICY QUESTION
What documentation does Plan 42 require for lumbar spinal fusion?
POLICY RESPONSEPrior authorization required
4 SOURCESREQUIRED DOCUMENTATION
- ✓ Imaging demonstrating instability
- ✓ Six weeks of conservative treatment
- ✓ Specialist evaluation
- ✓ Relevant neurological findings
◎ Every response is grounded in your plan’s policies—not the open internet.
OPERATIONAL IMPACT
Make policy operations
dramatically more efficient.
50%Faster policy configuration
30%Less reviewer preparation time
100%Source-linked outputs
24/7Policy change monitoring
Example operational targets. Results vary by deployment.
EXPLAINABILITY BY DESIGN
Intelligence you can audit.
Frontier Stack doesn’t replace your policies. It makes them operational.
01POLICY RESPONSE↓
02POLICY RULE↓
03SOURCE PASSAGE↓
04DOCUMENT VERSION↓
05EFFECTIVE DATE
✓
Source grounded
Every result connects directly to authoritative plan policy.
✓
Version controlled
Know exactly which policy version informed a workflow.
✓
Human governed
Escalate ambiguity and clinical judgment instead of hiding uncertainty.
✓
Observable
Track how rules are interpreted and used across your organization.
SECURITY
Built for enterprise healthcare.
Designed for enterprise security and healthcare data environments.
01Security architecture↗
02Enterprise access controls↗
03Encryption in transit and at rest↗
04Audit logging↗
05Environment isolation↗
06Data retention controls↗
07API security↗
BUILT AROUND THE HEALTH PLAN
One intelligence layer.
Every team aligned.
FRONTIER
STACK
STACK
Chief Medical OfficerClinical consistency
Utilization ManagementLess repetition
Clinical OperationsStandard workflows
IT & DataPolicy APIs
ComplianceProvenance & change
Provider OperationsClearer requirements
COMPANY
Built for the systems behind healthcare.
FOUNDER
Dr. Ujjwal Sinha
Frontier Stack was founded by Dr. Ujjwal Sinha, who brings more than 20 years of experience in healthcare. He is building Frontier Stack around a straightforward conviction: health plans need policy intelligence that is rigorous, explainable, and operationally useful.
View Dr. Sinha on LinkedInDESIGNED TO FIT
Don’t replace your core systems.
Make them intelligent.
Frontier Stack connects to the systems your teams already use, creating a reusable policy intelligence layer across the organization.
POLICY SOURCES↓
FRONTIER STACKPolicy Intelligence
APIPA PlatformClaims EngineCRMProvider PortalMember AppAnalytics
THE NEXT OPERATING LAYER FOR HEALTH PLANS
Put your policies
to work.
See how Frontier Stack turns healthcare policy into structured, explainable, operational intelligence.
INTRODUCTORY CONVERSATION
Explore where policy intelligence can remove friction from your operations.
Tell us about your organization, team, and priorities. We’ll use that context to shape the conversation.