Client Success Stories

"Our previous billing company was simply writing off complex NCCI bundling edits as 'unpayable.' Prismatica Health audited our aging backstock, crafted perfectly sourced medical necessity appeal letters utilizing Modifier 59 logic, and successfully recovered nearly $200,000 in claims we thought were dead. Their denial management team is unmatched."

"We were terrified of Medicare audits, so our internal team was downcoding every high-level complex E/M visit to a safe Level 3. Prismatica Health?s certified coders stepped in, implemented immediate CDI training for our physicians based on the new MDM guidelines, and legally restored our Level 4 and Level 5 billing. Our revenue jumped 18% with zero compliance risk."

"Our nursing staff was spending over four hours a day on the phone with Blue Cross just trying to get routine joint injections authorized, which completely stalled patient care. Prismatica Health?s authorization unit took over the entire process using the ePA portals. Our procedure schedule is completely full, and CO-197 denials dropped to absolute zero."

"We assumed our in-house billing was fine because cash was coming in. Prismatica Health?s free audit revealed that our staff was systematically ignoring all secondary crossover claims and failing to appeal simple CO-16 denials. That single audit uncovered $140,000 in recoverable revenue we were about to write off."

"Credentialing new providers used to take us 6 months, severely delaying our ability to expand our clinic locations. Prismatica took over our CAQH and PECOS updates. Our last three hires were fully in-network and billing within 90 days. Their credentialing team is simply fantastic."