AP-012
Other NHL, 65 to 74, rural, commercial, over 150 miles
Allo-HCT · Phase 1, Diagnosis & Referral · 19 days in stage · 16 barriers, 5 blocking
Delivery
Navigation plan
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 flagreferred 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 center9 days overdueAwaiting a response from the payer
Step 2 · Be accepted as a candidate
2 flagsthe center recommends treatment
In the way: Caregiver & psychosocial clearance · Eligibility / patient-selection hurdles
Request a fast-track, shared referrer–center eligibility assessment
Treatment-center teamReach: Treatment centerDue in 8 daysPush for fitness-based (not age-based) selection using real-world evidence
Treatment-center teamReach: Treatment centerDue in 10 daysConfirm the center’s caregiver requirement and any flexibility
Nurse navigatorReach: Treatment centerDue in 30 days
Step 3 · Secure approval to proceed
2 flagsauthorization and coverage in place
In the way: Single-case agreement / out-of-network · Insurance coverage & prior-authorization
Start the single-case agreement / out-of-state enrollment as early as possible
Treatment-center teamReach: Payer / health planDue in 20 daysVerify benefits and secure prior authorization before apheresis
Treatment-center teamReach: Payer / health planDue in 21 daysSecure authorization before apheresis to avoid a stalled start
Treatment-center teamReach: Payer / health planDue in 30 days
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
5 tasksEnsure disability accommodations so assessment is equitable
Nurse navigatorReach: Treatment centerDue in 9 daysFast-track the pre-apheresis work-up to shorten decision-to-vein time
Treatment-center teamReach: Treatment centerDue in 10 daysUse a standardized identification trigger (If they RECUR, refer)
Referring / community oncReach: Internal — no outside contactDue in 16 daysSet up a single point of contact / intake coordinator with the center
Nurse navigatorReach: Treatment centerDue in 18 daysArrange prehab / optimization to improve pre-treatment fitness
Nurse navigatorReach: Treatment centerDue in 18 days
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.