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AP-001

LBCL, 65 to 74, rural, Medicaid, out-of-network

CAR-T · Phase 3, Coverage & Authorization · 33 days in stage · 16 barriers, 6 blocking

Falling behindOne task is 5 days overdue

Delivery

Navigation plan

12 tasks are on this plan, 5 still open. The engine suggests 48 in total from this patient's barriers, so 36 have no owner yet. Statuses persist here.

Completion criteria, in order

Three things that each have to be true before treatment can happen. Work here unblocks everything downstream, which is why it sits above the rest of the plan rather than inside it.

Step 1 · Reach a center

1 flag

referred and accepted for evaluation

In the way: Late referral / progression before treatment

  • Refer early — at first relapse / by 2nd line; do not wait

    Referring / community oncReach: Treatment center36 days overdue
    Done

Step 2 · Be accepted as a candidate

2 flags

the center recommends treatment

In the way: Caregiver & psychosocial clearance · Eligibility / patient-selection hurdles

  • Push for fitness-based (not age-based) selection using real-world evidence

    Treatment-center teamReach: Treatment center36 days overdue
    Done

  • Request a fast-track, shared referrer–center eligibility assessment

    Treatment-center teamReach: Treatment center36 days overdue
    Done

  • Confirm the center’s caregiver requirement and any flexibility

    Nurse navigatorReach: Treatment center5 days overdueAwaiting a response from the payer
    Blocked

Step 3 · Secure approval to proceed

3 flags

authorization and coverage in place

In the way: Single-case agreement / out-of-network · Insurance coverage & prior-authorization · Coverage lag after approval

  • Check the payer’s current medical policy and timeline before committing

    Nurse navigatorReach: Payer / health planDue in 6 days
    In progress

  • Start the single-case agreement / out-of-state enrollment as early as possible

    Treatment-center teamReach: Payer / health planDue in 8 days
    Not started

  • Verify benefits and secure prior authorization before apheresis

    Treatment-center teamReach: Payer / health planDue in 9 days
    Not started

  • Secure authorization before apheresis to avoid a stalled start

    Treatment-center teamReach: Payer / health planDue in 11 days
    In progress

Feasibility and support

Work that makes treatment possible and bearable rather than permitted. Regroup it along whichever axis matches how you are working today.

Refer & establish candidacy

4 tasks

  • Set up a single point of contact / intake coordinator with the center

    Nurse navigatorReach: Treatment center36 days overdue
    Done

  • Use a standardized identification trigger (If they RECUR, refer)

    Referring / community oncReach: Internal — no outside contact36 days overdue
    Done

  • Fast-track the pre-apheresis work-up to shorten decision-to-vein time

    Treatment-center teamReach: Treatment center36 days overdue
    Done

  • Arrange prehab / optimization to improve pre-treatment fitness

    Nurse navigatorReach: Treatment center36 days overdue
    Done

Handoffs

An explicit transfer of responsibility, tracked separately from tasks because the failure mode is different: nobody is late and nobody is idle, the work simply has no owner until somebody acknowledges it.

Referring / community oncNurse navigator

Referral received and accepted for work-up.

Acknowledged

Every task traces back to a barrier that actually fired for this patient.

  • The plan is not separate authoring. It is the assessment projected forward.
  • That is what makes it maintainable at all.