Intended outcome
Recover viable balances while separating payer problems, workflow problems, enrollment problems, and documentation problems.
Recover viable balances while separating payer problems, workflow problems, enrollment problems, and documentation problems.
Recover cash and prevent recurrence
PRISM segments aging, classifies denials, works corrected claims and appeals, reviews underpayments, monitors timely filing, and translates recurring defects into corrective action by payer, program, code, provider, location, and workflow.