A trained predictive server is provided for determining that a diagnosis and treatment plan is inaccurate. The trained predictive server includes a processor configured to receive a set of prior authorization (PA) data associated with a medical claim for a patient, and determine that the PA data indicates that the medical claim is associated with a qualifying critical illness and control use of medical devices. The processor can extract component data from the set of PA data, and apply the extracted component data to a predictive model associated with the qualifying critical illness to determine whether the medical claim is associated with an inaccurate diagnosis and treatment plan. Upon determining that the medical claim is associated with an inaccurate diagnosis and treatment plan, the processor can generate a request for review of the diagnosis and treatment plan using the set of PA data and stop use of a medical device.
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What is claimed is: