Claims Processing Certification – Focuses on the grouping of claims into bundles and differentiating those associated with typical services versus potentially avoidable complications (PACs).
Claims and Provider Analysis Certification – Focuses on the use of Prometheus Analytics to sift through historical claims data and create severity-adjusted comparisons of episode costs attributed to providers.
Payment Implementations Certification – Focuses on the ability to implement the Prometheus Analytics Payment model, including creation of severity-adjusted prospective budgets for EOCs, and reconciliation of budgets to actual costs.
Providing Measurable Value
Episodes of Care
covered lives including commercial & Medicaid1
in claims analyzed annually2
1. Based on customer information & feedback 2. Internal CHNG data based on claims using Prometheus Analytics