Healthcare Revenue Cycle Analytics & Payment Integrity
Prizma Analytics Inc. helps healthcare organizations increase yield across the revenue cycle — pairing hands-on RCM consulting with proprietary cloud-based analytics, including our Expected Pay Engine (EPE)© platform.
Get in TouchWe help healthcare organizations continuously monitor and increase yield across the revenue cycle — from front-end analytics to payer contract performance — pairing hands-on consulting with proprietary cloud technology.
Our proprietary cloud platform calculates exactly what a payor should pay for any healthcare charge — deterministic, versioned, and fully auditable.
See how it works →Benchmark payer performance side-by-side, surface underpayments and contract variance, and turn payer data into negotiating leverage.
End-to-end visibility into charge capture, denials, AR aging, and payer mix — we leverage data to feed RCM worklists that point directly to yield opportunities.
We build custom solutions and workflows tailored to your organization — standardizing procedures and closing the process gaps that quietly erode reimbursement.
EPE is our cloud-based platform that calculates exactly what a payor should pay for any healthcare charge — with a complete, versioned audit trail for every pricing decision.
Same inputs, same reference data, same output — every time. Every calculation follows fixed, transparent rules with no hidden logic or black boxes, so results can be reproduced and independently verified on demand.
Includes Medicare Fee-for-Service, Medicare Advantage, and commercial fee schedules — spanning fixed-rate, percent-of-Medicare, and Chargemaster-based contracts, while handling complex pricing and payment policy calculations.
Every pricing decision is versioned and traceable. Billing disputes and compliance reviews are answered with evidence, not estimates.
Unrecognized data is flagged and suspended — never silently defaulted. Output is clean or it tells you precisely why it isn't.
All reference data is evaluated as-of service date, not execution date. Historical reconstructibility is built in, not bolted on.
Delivered as a cloud service — nothing to install or maintain on your end. Core processes for billing and collections stay undisturbed; we capture, stage, and promote your data, requiring only a data feed in a simple, agreed-upon format.
EPE processes charges through a structured, auditable pipeline from ingestion through final expected pay calculation:
Prizma Analytics Inc. is a U.S.-based healthcare revenue cycle consulting firm focused on payment integrity and yield improvement.
Founded in 2022, Prizma was built by practitioners with many years of hands-on experience and in-depth industry knowledge of healthcare finance and revenue cycle. That grounding means we understand the key levers that drive reimbursement performance — and how to translate that knowledge into measurable yield improvement.
Across every engagement — revenue cycle analytics, process re-engineering, payer benchmarking, or our Expected Pay Engine platform — we hold to the same standard: recommendations grounded in evidence, not guesswork, so they can be fully explained and stand up to scrutiny, whether in a billing dispute, a compliance review, or a contract negotiation.
Ready to learn how Prizma Analytics can help increase yield across your revenue cycle? We'd like to hear from you.