Simplify Policy Management with Criteria That Follows the Formulary

If you’ve ever tried to manage prior authorization criteria across dozens—or hundreds—of plans, you know how quickly complexity spirals. Every plan has its own variations, every formulary update ripples through layers of duplicate policies, and each small change introduces a chance for inconsistency. It’s a tedious cycle that eats into team bandwidth, drives up administrative costs, and delays updates that should be instant.

Banjo Health’s Composer changes all that by taking policy management out of the plan-level maze and aligning it directly with the formulary itself. This architecture eliminates the need for redundant plan-based criteria and replaces it with a system that’s dynamic, centralized, and ready for real-time publishing.

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The Cost of Legacy Duplication

Traditional policy systems tie criteria to the plan rather than the formulary. That may have worked when formularies were simpler and less fluid, but in today’s environment—where drug coverage can shift across groups, lines of business, and regulatory timelines—it becomes an operational trap.

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Each formulary update demands repetitive edits across multiple plans. Even minor rule adjustments can spawn a wave of manual work, with staff tracking down which policies to update and where the changes should live. These duplications not only slow down turnaround time but also increase the risk of discrepancies between plans. The result: more touchpoints, more errors, and longer waits before new criteria can be confidently applied.

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Automation That Works Smarter

Composer flips the model. Instead of replicating criteria across plans, it ties every clinical rule directly to the formulary. This means when a formulary changes, the connected criteria automatically follow—no manual reconciliation, no version mismatch, no guesswork. This automation delivers immediate ROI: fewer administrative hours spent on maintenance, fewer compliance issues caused by version drift, and faster implementation of updates. Teams no longer spend days cross-checking spreadsheets or waiting for IT to deploy changes. They can build, publish, and retire criteria from one intuitive interface—no coding required.

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Fewer Touchpoints, Faster Decisions

The impact extends far beyond internal efficiency. Fewer manual steps mean cleaner data and faster case processing. When reviewers access criteria that’s automatically current and linked to the right formulary version, they spend less time validating information and more time focusing on clinical appropriateness. Every automated update eliminates a potential delay in prior authorization turnaround time. Over time, those minutes compound into measurable savings in both labor and operational throughput. The system doesn’t just make things easier—it makes them faster and more reliable.

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Compliance Through Control

Composer’s built-in version control and auto-numbering ensure every change is traceable. Compliance teams can instantly see when and why a rule changed and publish updated criteria without waiting for a manual rollout. That level of transparency simplifies audits and reduces the risk of outdated policies slipping through review cycles. Instead of retroactively explaining discrepancies, you can proactively demonstrate alignment and control.

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The Bottom Line: Modern Policy Management That Scales

The return on investment for automation isn’t abstract—it’s measurable. By centralizing formulary-linked criteria, payers and PBMs eliminate redundant maintenance, cut cycle times for policy updates, and reduce the cost of compliance. Banjo’s Composer turns what used to be a slow, error-prone process into a responsive, data-driven system that scales effortlessly as your business and formularies evolve.

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If your team is ready to move past the bottlenecks of plan-level duplication and legacy updates, it’s time to explore how Banjo’s Composer can simplify your world.
Discover how to build, publish, and retire criteria in one place—no coding required.

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