1. A presentation from
Improving the payer revenue model.

2. We know when policies
change, so we can
help you prevent and
fight denials and
recoupments.
2

3. MGMA (Medical Group Management
Association)
Why only 35%?
•Too time intensive
•High costs
•No tools for policy-based defense
“Only 35% of practices
appeal denials.”
3

4. Why Compliance PT?
Frequent payer policy changes
are difficult to track and
understand in a real-time billing
environment.
Payers benefit from this chaos,
so the burden has shifted to
providers to keep pace with this
constant stream of policies
changes.
Our Product Thesis:
Providers need a better defense.
4
Total Industry Policy Change Growth 2000 – Current*

5. Decrease Denials
Reduce Recoupments
Improve Efficiency
What We Do
5
Notification Summaries Tool Kit
Over 100,000 policy changes occurred last
year alone. We found that many denials
were due not to miscoding, but because
policies had changed in small but important
ways with little or no notification to billers,
providers and hospital systems.
Our Policy-Based Defense software keeps
your billing and coding rules current, explains
complex policy changes in plain English to
your biller coders, and provides tools to fight
denials and recoupments efficiently and

6. Timely
Notifications
Receive notifications when payer
policies change that affect your
billing. Know about changes
before billing mistakes happen.
6

7. Professional
Summaries
Our billing experts break down
complex policy changes into
actionable updates for your staff.
7

8. Full
Toolkit
Use our forensic tools to deep
dive into ever-changing payer
policies and prove medical
necessity.

9. Policy Change
Compliance PT automatically
sends you relevant billing
rule updates
Respond with policy-
based proof in your
denial response
Provider
Updates EMR
Denial or Recoupment
Notice from Payor(s)
9
Billing Lifecycle Accepted
Revenue
Revenue

10. • Real time medical policy change
notifications to your biller coders and
other staff.
• Notes from our experts on the latest
policy requirements enable you to file
more meaningful initial claims.
• Create immediate internal changes to
medical documentation requirements
to prevent denials and recoupments.
What You’ll Receive…
10

11. When our ancillary care business received a $240,000
recoupment notice after a single policy had changed without
our knowing, we knew we had a new mission. We started
Compliance PT the following day.
“
11
“
Brian Panessa CEO, Compliance PT

12. 800.927.3495
compliancept.com
info@compliancept.com
Contact Us
1776 Peachtree Street
NW Suite 423 S
Atlanta, Georgia 30309