Solutions For Health Plans

With PRIME, your data is always up to date

Provider Data Accuracy
AI-Powered Tools
Provider Directory Fulfillment
Ongoing Monitoring
Mock Audit Preparation
Provider Training
Provider Data Accuracy
Provider Directory Fulfillment
Ongoing Monitoring
Mock Audit Preparation
Provider Training

Provider Data Accuracy

PRIME is unique because it relies on direct outreach to contracted Health Systems, Provider Groups, and Individual Practitioners. We offer convenient validation channels tailored to the capabilities of your Providers – achieving success rates of 95% in confirming provider data.

We also make sure your directory adheres to Federal (CMS) compliance standards, state regulatory compliance such as CA SB137, and the requirements of the No Surprises Act. Our solutions are also designed to be compatible with FHIR, facilitating seamless integration and data exchange.

PRIME also utilizes an intuitive, browser-based dashboard – an all-in-one window into your findings and attestation progress. You can use our AI-driven Ask PRIME engine to ask almost any question that you would like to answer from your data – with answers arriving in seconds!

AI-Powered Tools

PRIME is leveraging Artificial Intelligence (AI) to take provider data management and validation to new levels. Through our customizable dashboard, we are using AI to give clients unprecedented access to their own directory findings and trends. Our Ask PRIME engine let’s clients ask any question – about trends in listing changes, regional patterns, and more – and get answers in seconds.

Provider Directory Fulfillment

Instant, High-Quality, Print-Ready, ADA-Compliant Provider Directories

PRIME can help you enhance customer experience and usability by delivering your directory in a print-ready PDF format – or as printed books. CMS also mandates that physical printed directories be made available for patients over 65 years old – we take care of this important requirement for you, as well.

To facilitate timely updates of the provider data stored in your Provider Data Management System, Atlas also enables automated integrations with the PRIME platform

Ongoing Monitoring

Enhance Your Relationship with Providers

We ensure the validity of providers in your network by continuously monitoring for expired licenses and registrations, sanctions, and deceased providers. PRIME relies on access to resources such as the Limited Access Death Master File (LADMF) – which captures Social Security numbers of deceased individuals – to be sure your directory stays current and accurate.

Providers: Update Your Data In One Place

PRIME can coordinate and provide data updates to all your affiliated Health Plans

Mock Audits Preparation

Be Ready for Your Next Audit

PRIME can assist with the identification of data errors and anomalies to help prevent potential compliance violations in advance of an actual audit. We have extensive experience with audit preparation, including mock CMS and state provider directory audits.

Provider Training

Online Training

PRIME uses state-of-the-art technology to provide a positive, structured, and fully customizable training experience which ensures that providers in your network are fully trained for delivering quality care!

Build competencies

Log attendance lists and incorporate competencies related to specific job functions. Competency Training modules include Integrity and Compliance, Fraud and Abuse, Cultural Competency, HIPAA, Confidentiality, and CMS Special Needs Plan Model of Care (SNP MOC)Integrity and Compliance, Fraud and Abuse, Cultural Competency, HIPAA, and Confidentiality.

Follow Up

Our direct outreach methods provide personal follow-ups for your Providers to complete their required training. We track their training progress and send each Provider a certificate upon completion.