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Behavioral health revenue integrity, built upstream.Cincinnati, Ohio · Serving behavioral health organizations across Ohio
Revenue cycle management for behavioral health

Operational relief you can feel. Revenue integrity you can measure.

PRISM helps behavioral health organizations align access, authorization, documentation, coding, claims, denials, payment posting, and reporting into one accountable system.

We are not a generic billing vendor. We are a revenue cycle and clinical systems partner built for mental health, substance use, community-based services, and growing provider organizations that need their clinical work to become defensible, collectible revenue.

End-to-endFrom intake and eligibility to final payment and reporting
Built upstreamWe solve documentation and authorization issues before they become denials
Behavioral health fluentSpecialized for MH, SUD, community services, and complex payer workflows
Revenue integrity firstWe trace problems back to root causes instead of treating denials like random weather.
Clear governanceClaim-hold standards, escalation pathways, and executive dashboards create accountability.
Practical implementationDiscovery, diagnostic, pilot, and management rhythm designed for real provider organizations.
Founders who know the workClinical systems and billing leadership under one roof.
Why PRISM

The strength of many capabilities in one trusted revenue cycle partner.

PRISM brings together billing operations, clinical documentation insight, denial recovery, authorization discipline, and executive reporting so provider organizations stop managing disconnected vendors and fragmented workstreams.

Built for organizations that need more than claim submission.

Providers lose revenue upstream. The wrong level of care, an untracked authorization, a weak treatment plan, a late note, an unenrolled rendering provider, or an unmonitored denial queue can all wound the claim long before a bill ever drops. PRISM addresses the entire chain.

  • Behavioral health specialization across mental health and substance use service environments
  • Payer-rule awareness, utilization discipline, and authorization threshold monitoring
  • Documentation and claim-integrity review designed to support defensible reimbursement
  • Transparent monthly reporting on collections, denials, aging, and process bottlenecks
A
Align the front end

Eligibility, enrollment, authorizations, and intake data are stabilized before they spill downstream.

B
Protect the middle

Documentation, coding, and medical necessity are reviewed as operating controls, not afterthoughts.

C
Recover the back end

Claims, denials, A/R, payment posting, and underpayments are actively worked with measurable accountability.

D
Lead with data

Executive dashboards translate billing activity into operational decisions leadership can actually use.

Service architecture

A complete revenue cycle structure, organized the way healthcare cash flow actually works.

We organize our work across pre-cycle, mid-cycle, post-cycle, and advisory functions so leaders can see where revenue is being protected, delayed, or lost.

P
Pre-cycle

Access, eligibility, and authorization

We strengthen the front-end controls that determine whether a service ever has a clean path to reimbursement.

  • Provider and payer enrollment support
  • Eligibility and demographic review
  • Authorization tracking and continued-stay support
  • Utilization and threshold monitoring
M
Mid-cycle

Documentation, coding, and claim integrity

PRISM helps make sure the record, the code, and the service line all tell the same truthful story.

  • Documentation sufficiency and signature review
  • Medical necessity and treatment-plan alignment
  • Behavioral health coding and unit review
  • Claim-hold and escalation criteria
R
Post-cycle

Claims, denials, payments, and A/R

We execute the operational work that turns properly delivered services into timely collections.

  • Claim scrubbing and submission
  • Rejections, denials, and appeals
  • Payment posting and reconciliation
  • Aging review and accounts-receivable follow-up
S
Strategy

Leadership, analytics, and growth support

We convert rev cycle activity into executive information that can guide staffing, compliance, and expansion.

  • KPI dashboards and trend reporting
  • Revenue integrity diagnostics
  • Workflow redesign and staff training
  • Fractional RCM and clinical systems leadership
What partnership should feel like

Measured, transparent, and strong enough to challenge the status quo.

PRISM is designed to work like an accountable operating partner: clear standards, honest reporting, timely escalation, and a willingness to confront process failures before they become financial losses.

We do not hide behind activity.Reports should show what moved, what stalled, what was denied, and what needs executive attention.
We believe claim integrity is a systems issue.When the same denial appears repeatedly, the work is to redesign the process, not just rework the bill.
We respect the clinical reality.Behavioral health revenue cannot be stabilized if documentation, level of care, and treatment planning are ignored.
We build for durable control.The goal is not merely to recover dollars today but to give the organization a stronger revenue engine tomorrow.
“Most billing problems are not billing problems. They are system problems wearing billing clothes.”

That is the PRISM operating thesis. We look beyond the claim itself to the upstream conditions that shape whether the organization gets paid, gets delayed, or gets denied.

PRISM Revenue Cycle & Clinical Systems · Behavioral health revenue integrity built upstream
Leadership

Founders with complementary expertise in billing operations and clinical systems.

PRISM sits in the narrow but valuable space where care operations meet reimbursement. That requires fluency in both worlds.

K

Keisha Nelson

Co-Founder · Revenue Cycle Operations

Keisha brings deep experience in medical billing, charge compliance, office administration, training, and workflow management. Her background includes billing supervision, multisite operations, practice systems training, and process improvement.

  • Certified Professional Coder (CPC) and Certified Internal Medicine Coder (CIMC)
  • Revenue cycle leadership and billing supervision
  • Staff training, operational consistency, and workflow execution
  • Hands-on knowledge of practice management systems and payer processes
M

Michael Collins

Co-Founder · Clinical Systems & Strategy

Michael brings behavioral health executive leadership, clinical systems design, compliance framing, utilization management insight, and treatment documentation strategy. His work is rooted in aligning clinical practice with defensible reimbursement.

  • Licensed clinical and addiction professional with executive leadership experience
  • Behavioral health documentation, medical necessity, and level-of-care alignment
  • Operational design across outpatient, IOP, recovery, and community service settings
  • Strategic growth, governance, and systems architecture
How engagement works

A disciplined operating rhythm from discovery through sustained management.

We start with a clear picture of the current revenue cycle, define the highest-risk gaps, implement a controlled scope, and then govern performance through structured review.

1

Discover

We gather payer mix, workflow data, operational context, denial patterns, and available financial reporting to understand the current state.

2

Diagnose

We identify revenue leakage, authorization risk, documentation weaknesses, enrollment issues, and workflow bottlenecks.

3

Deploy

We implement the agreed service scope, assign accountability, establish claim-hold rules, and begin structured reporting.

4

Govern

We review KPIs, aging, denials, collections, and unresolved barriers so leadership can make informed operational decisions.

Frequently asked questions

Common questions from behavioral health leaders.

These answers reflect the way PRISM is designed to operate: specialized, controlled, and oriented toward measurable accountability.

Do you only submit claims?

No. PRISM is built as an upstream revenue cycle partner. We support the operational chain that influences whether the claim is clean, supported, and collectible.

Who is PRISM built for?

Behavioral health, substance use, and community-based organizations that need billing execution plus stronger documentation, authorization, and governance controls.

Can PRISM help if denials are already high?

Yes. We can assess denial patterns, isolate root causes, and recommend an implementation scope that targets the problems generating the most financial drag.

Do you provide leadership reporting?

Yes. PRISM emphasizes monthly reporting on collections, aging, denials, trends, and unresolved operational barriers so decisions are guided by data rather than guesswork.

Ready to talk?

Bring structure to the revenue cycle your organization is trying to hold together by sheer willpower.

If your organization is dealing with claim delays, authorization slippage, unclear workflows, weak reporting, or revenue that feels harder to explain than to earn, PRISM can help. Start with a discovery conversation or a focused revenue integrity review.