WinTheP2P
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Case Management2026-01-106 min read

Case Manager Guide: How to Help Your Physicians Win P2P Calls

A guide for case managers and UM nurses on how to support physicians through the P2P review process. Includes communication templates and workflow tips.

The Case Manager's Role in P2P Success

As a case manager, you do the bulk of the work -- gathering records, submitting authorizations, managing denials. But the P2P call itself falls on the physician. The gap between your preparation and the physician's readiness is where cases are lost.

How to Set Your Physicians Up for Success

Before You Schedule the P2P

  • **Summarize the denial in plain language.** Don't just forward the denial letter. Write a 2-3 sentence summary: "MRI lumbar spine denied by UHC for medical necessity. They want documentation of 6 weeks conservative treatment. We submitted 4 weeks of PT notes."
  • **Identify the gap.** What's the specific reason for the denial? What criteria weren't met? What additional information could change the decision?
  • **Gather supporting documents.** Pull the relevant clinical notes, imaging reports, and guideline references before the call, not after.

    • When You Schedule the P2P

    Send the physician everything they need in one message:

  • Denial summary (2-3 sentences)
  • Key clinical facts to emphasize
  • What criteria the payer used
  • A link to prep: winthep2p.com/prep

    • After the P2P

    Document the outcome immediately:

  • Was the denial overturned?
  • Were additional documents requested?
  • Is a written appeal needed?
  • What's the timeline for the decision?

    • Communication Template

    Here's a template you can customize when notifying a physician about a P2P:

    Subject: P2P Scheduled -- [Patient Name] -- [Procedure]

    Dr. [Name],

    P2P call scheduled for [date/time] with [payer] regarding [procedure] for [patient].

    Denial reason: [1-2 sentence summary]

    Key points for the call:

  • [Point 1]
  • [Point 2]
  • [Point 3]

    • Prep tool (generates a script in 60 seconds): winthep2p.com/prep

    Please let me know the outcome after the call so I can update the case.

    Building a P2P Culture

    The most effective UM teams make P2P preparation a standard workflow step, not an afterthought. When every denial that goes to P2P includes a prep step, overturn rates improve across the board.

    *Want to make P2P prep automatic for your team? Learn about enterprise plans for multi-user access.*

    Ready to prep for your P2P call?

    Generate a structured script in 60 seconds. No account required.