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 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 — turned into clear, actionable KPIs that point directly to yield opportunities.
We redesign front, middle, and back-office workflows — standardizing procedures and closing the process gaps that quietly erode reimbursement.
EPE is our cloud-based analytics 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.
Covers Medicare Fee-for-Service, Medicare Advantage, and commercial fee schedules — including percent-of-Medicare and fixed-rate contracts.
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.
Built entirely in T-SQL stored procedures and delivered as a cloud service — nothing to install or maintain on your end. 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 Texas-based healthcare analytics and 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 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.