PRISM utilizes advanced analytical tools to assess the value of a
provider network, or the comparative values of multiple provider
assessment can target network negotiated fees, network access with
current utilization patterns and steerage capabilities.
Determine if one or more provider networks provides adequate
coverage for a member population.
Assess the effectiveness of a provider network relative to covered
Determine if a network has cost effective providers.
Compare relative negotiated fee levels.
Identify current provider utilization patterns.
Evaluate if a specialty carve out network is needed for certain
Provider Network Analysis Services
The client specifies the dimensions of a Provider Network Analysis
and the data comparisons to be made.
The initial report details the analysis and makes recommendations.
Ongoing access to reporting capability is maintained to evaluate the
Obtain provider lists and negotiated fees from networks.
The client or administrator provides claims data for a one year
Data is mapped into a sophisticated analytical system.
Initial and ongoing reports are created and generated.
Contact PRISM Healthcare Resources LLC for a demonstration of