Five stages between your question and a defensible answer
1 Research fan-out
Parallel automated research pipelines sweep the primary sources, including payer medical policies, Medicare and MAC positions, fee schedules, CPT and HCPCS code histories, coverage databases, peer-reviewed literature, regulatory records, and claims data where in scope. Each pipeline works a different angle so a miss in one lane gets caught by another. A senior market access expert, matched to your product and payer mix at scoping, directs where the sweep digs deepest.
2 The claims ledger
Every factual claim that will appear in the deliverable is logged as a ledger entry holding the statement, its source URL, its retrieval date, and a confidence tier. Tier A claims carry primary sources. The ledger is the deliverable's skeleton; nothing appears in the report that does not trace to a ledger row.
3 Adversarial verification
A separate verification pass, with no stake in the draft, attacks the ledger, re-fetching sources, re-deriving every computed number independently, and hunting the failure modes we have catalogued from our own builds.
4 The lint gate
An automated shipping gate checks the assembled deliverable against the ledger. Unverified claims, broken citations, stale retrieval dates, and internal contradictions all block release.
5 Expert in the loop
The expert has been in the loop since scoping. Here the review is formal. Every deliverable also gets the founder's read for decision usefulness (does this tell an operator what to do next), and work headed for a payer, the AMA, a physician society, or your board gets the panel expert's review for strategy and tone (will it read credibly to the people who decide). Human judgment is the final, and most important, gate.
Each ledger entry carries its source, the date it was checked, and its status
Sample entries from a demonstration ledger. Fictional device (the Northwind Cadence Thermal Probe, code 0X12T), real payers and contractors, illustrative figures.
| Entry | Claim | Source | Checked | Status |
|---|---|---|---|---|
| L-0012 | Category III code 0X12T describes thermal ablation with the probe and took effect 1 July 2025. | AMA CPT Category III release, January 2025 | 6 Oct 2026 | Verified |
| L-0047 | Novitas JH lists 0X12T on its contractor-priced fee schedule at $1,019.00 in the office setting. | Novitas JH fee schedule, third quarter 2026 | 6 Oct 2026 | Verified |
| L-0083 | UnitedHealthcare classifies the procedure as unproven and not medically necessary. | UnitedHealthcare Medical Policy, reviewed 1 March 2026 | 6 Oct 2026 | Verified |
| L-0091 | Aetna lists the procedure as experimental and investigational in its policy on tissue ablation. | Aetna Clinical Policy Bulletin, reviewed 30 December 2025 | 6 Oct 2026 | Verified |
| L-0102 | Medicare paid 84 percent of adjudicated claims in the seventeen priced states over the last 18 months. | Computed from Medicare remittances | 6 Oct 2026 | Re-derived |
The verification trail is the product
Any firm can hand you a confident PDF. The question is what happens when your board member, your investor, or a payer medical director starts to dig in. With a Praxa deliverable, the answer is one click away, showing the claim, its source, the retrieval date, and the verification status.
This is also why we are able to price transparently. The repeatability comes from automation; the trust comes from a trail no hourly model produces.
The rules we hold ourselves to
| Standard | In practice |
|---|---|
| Every claim traces to a source | If we cannot cite it, we do not ship it. Estimates and inferences are labeled as such, with the reasoning shown. |
| Numbers are recomputed independently | Any figure we calculate gets re-derived by a second, independent pass before it appears in a deliverable. |
| Uncertainty is highlighted | Where the record is ambiguous or a payer position is unpublished, the deliverable says so and states what would resolve it. |
| Simulations are backtested before they are sold | Roundtable personas are validated against real coverage decisions held out from their construction, and the fidelity scores ship with the deliverable. We will not sell a simulation we have not scored. |
Audit us
Ask any market access vendor how their claims are verified and who checks the checker. Then ask us. We like this question.