PRIZM is a leading provider of medical management services. Insurers rely on PRIZM's proprietary platform, applications and services to manage personal injury protection (PIP) and medical liability cost containment and care.

Customer Care

We make sure our clients’ needs are met from the instant the claim is submitted to the moment the file is closed. Our highly-trained and experienced staff responds within minutes because time matters.

Dynamic Lifecycle Application

PRIZM offers a web-based, zero install platform and integrated medical case management platform to manage the claims process and ensure billing accuracy. Our application is a purpose-built product that will deliver quick, data-secured information at the correct time to the correct person throughout the life of the claim.

Sustainability

We work in a true paperless environment. Our platform and applications enable clients to eliminate waste and reduce the use of natural resources in their day-to-day activities.

PRIZM offers integrated solutions that streamline processes throughout the entire claim life cycle. 

Services

  • Audits: DRG Validations
  • Bill Review
  • First-Party Bill Review and Third-Party Bill Review
  • Fee Schedule Affidavits and Testimony by Certified Professional Coder
  • Case Management
  • Code Review
  • Dispute Support
  • Film Review
  • Independent Medical Exams
  • Legal Bill Review
  • Peer Review: Bodily Injury, Disability, PIP and Workers' Compensation
  • Pre-Certification
  • Utilization Review
  • State Solutions:

FL: House Bill 119 Automation

NJ: Auto Adjudication of Bills Against Treatment Plan

NY: Automated NF 10s, Auto Delay Process, NY Surcharge

Selected Bells and Whistles

  • Virtual Mail Room: same day imaging / indexing with double mapping available
  • Mailings: generation and distribution of mandated notifications
  • Provider Call Center 
  • Dr. Portal
  • Documents notifications 
  • Clinical Adjuster Education
  • Faxing
  • Year End Reviews
  • Internal QA
  • Business Intelligence:
    • SIU Global
    • Average Days to Pay a Bill by Hour of Day
    • Code Review Compliance Report of previous day activity