Navigate healthcare's administrative system
Healthcare's administrative system is largely procedural. Insurance policies, billing codes, authorization rules, and documentation requirements follow structured logic, governed by policies, workflows, and institutional incentives. Compass interprets that system for your specific situation: analyzing rules, identifying the procedural logic behind decisions, and generating strategic guidance you can act on.
Administrative decisions shape your access to care
Healthcare runs on rules that most patients never see. Insurance companies, billing departments, and utilization reviewers make decisions using internal criteria, procedural knowledge, and documentation thresholds. Compass gives you the same structural understanding.
Insurance rules are opaque
Coverage criteria, step therapy requirements, and authorization rules vary by insurer, plan, and state. The information exists, but it is fragmented across hundreds of policy documents that patients rarely encounter.
Administrative decisions require system knowledge
A denied claim, a rejected prior authorization, or an unexpected bill each follows a specific procedural logic. Understanding that logic is the first step toward changing the outcome.
Documentation determines access
What is documented in your medical record, and how it is documented, directly determines whether treatments are approved, claims are paid, and referrals go through. Documentation is access.
Four domains of administrative intelligence
Compass organizes healthcare's administrative landscape into four areas where system knowledge changes outcomes.
Denial Intelligence
Interpret insurance denial letters, classify denial categories, identify appeal strategies, and generate structured appeal documentation.
Billing Intelligence
Analyze medical bills and Explanations of Benefits, identify billing errors, understand charge structures, and develop dispute strategies.
Authorization Pathways
Map prior authorization requirements by insurer and procedure, plan submission strategies, and navigate step therapy and formulary rules.
Coverage Interpretation
Parse plan documents, identify coverage rules and exclusions, understand network requirements, and evaluate benefit applicability.
The Compass Intelligence Engine
Compass is powered by a structured reasoning system designed to replicate the analysis that experienced healthcare administrators perform.
Document and signal ingestion
Parses denial letters, Explanations of Benefits, bills, policy documents, and medical records.
Healthcare ontology and rules graph
Maps relationships between diagnosis codes, procedure codes, insurer policies, and administrative rules.
Case classification engine
Determines the true category of the user's problem across denial types, billing issues, and authorization barriers.
Expert heuristic engine
Encodes decision patterns used by billing specialists, utilization reviewers, and patient advocates.
Evidence and policy retrieval
Pulls relevant insurer policies, clinical guidelines, and documentation requirements for the specific situation.
Action strategy generator
Produces clear tactical guidance and recommended next steps tailored to the user's case.
Outcome learning layer
Improves strategy recommendations over time based on results across similar cases.
From document to strategy in minutes
Upload your documents
Paste text, upload a PDF, or snap a photo. Compass reads denial letters, Explanations of Benefits, bills, and coverage documents, extracting the relevant details automatically.
Compass analyzes the rules
The system classifies your situation, matches insurer-specific rules from its database, and identifies the procedural logic governing the decision you are facing.
Get strategic guidance
Receive tailored documentation: appeal packets, billing dispute letters, authorization strategies, or coverage analysis, along with deadlines, submission instructions, and escalation paths.
PriorAuthPro: Insurance appeal packets
PriorAuthPro is the first live module within Compass, focused on prior authorization denials. Upload your denial letter and get a complete, professional appeal packet in minutes.
What you send to the insurer
Includes appeal cover letter with proper clinical language, care timeline, clinical summary, policy criteria mapping, letter of medical necessity template for your provider, and evidence exhibit list.
Your internal prep materials
Includes evidence checklist, step-by-step submission instructions for your insurer, deadline worksheet, escalation overview with state-specific external review paths, and pre-export validation warnings.
Five denial categories. Ten insurers. Twenty-two states.
PriorAuthPro classifies every denial and tailors the appeal accordingly. Each category gets a different strategy, different language, and different supporting evidence requirements.
Procedural
Authorization not on file, untimely request, wrong process, administrative error. The appeal focuses on correcting the procedural issue and documenting proper authorization.
Medical necessity
Insurer says the treatment is not clinically indicated. The appeal builds a clinical case with evidence, guidelines, and provider attestation.
Benefit exclusion
Service not covered under plan terms. The appeal examines coverage language, identifies potential misapplication, and builds arguments for coverage.
Coding / billing error
CPT/ICD mismatch, incorrect procedure code, bundling issue. The appeal identifies the coding error and provides corrected information.
Documentation insufficiency
Insurer says submitted records were incomplete. The appeal identifies what's missing and helps you compile and resubmit the required documentation.
Insurer-specific rules and deadlines
Compass maintains a database of insurer-specific appeal requirements, updated regularly. When your insurer is in the database, you get exact deadlines, fax numbers, submission addresses, and required documentation lists.
Aetna
BCBS
UnitedHealthcare
Cigna Healthcare
Humana
Anthem / Elevance
Kaiser Permanente
Centene / Ambetter
Molina Healthcare
Health Net
Insurers not in the database are fully supported. Compass generates complete packets using AI analysis and instructs you to reference your denial letter for submission details.
$59 per appeal packet
One price. Complete packet. No subscription, no recurring charges, no hidden fees. Pay when you need it, and get your documents in minutes.