About
Built by people whofought the denials first.
Prisym is the policy intelligence product of Just Healthcare Solutions, a team of clinicians, revenue cycle veterans, and engineers who spent years reading payer policies by hand and decided a machine should do the reading.
Mission
Every payer has coverage rules. Everyone should be able to follow them. We built Prisym so that a clinic in one state and a health system in fifty can both answer the same question in seconds: what does this payer require, today, for this patient.
How we work
Principles that shape every part of the system.
- 01
The payer's policy is the authority.
We keep its language intact and never edit it. Extracted fields are a way to find and compare, and they carry their confidence.
- 02
Nothing is ever overwritten.
Claims disputes turn on the policy in effect on a date of service. Every version is kept, so that question always has an answer.
- 03
Automation runs unattended. Humans handle the exceptions.
The system tracks, extracts, and versions on its own. Anything it is not sure of goes to a review queue, and nothing uncertain enters the live catalog.
- 04
Evidence over opinion.
Every answer points back to the payer's own policy language. If Prisym cannot show you where a criterion comes from, it does not assert it.
Part of a suite
Prisym runs on its own and inside JustAppeals.
A determination in Prisym can hand off directly to a submission package, a peer-to-peer brief, or an appeal in the JustAppeals suite. Just Connect links all of it to the EHR and payer portals you already run.
Submission Co-Pilot™
Approval likelihood and gap detection before a request goes out.
P2P Co-Pilot™
A one-page brief for the peer-to-peer call, grounded in the reviewer's own policy.
Responder™
Stage-aware appeal letters that quote the payer's policy and the evidence.
Just Connect™
EHR, payer portal, and document connections for every product.
Security
Designed so the sensitive part never has to leave your building.
No PHI required
The library, matrix, and alerts run on payer policy alone. Determinations use de-identified facts you choose to enter.
Encrypted in transit and at rest
TLS everywhere; policy data encrypted at rest with access scoped to your organization.
Scoped access
Accounts are provisioned by your administrator. API tokens are per organization and can be rotated at any time.
Complete audit trail
Every catalog change records the actor, a scheduled run, a model, or a named reviewer, with its evidence.
Compliance documentation is available to customers on request.
Want to talk to the team?
We are happy to walk through the platform, the roadmap, or how Prisym fits with the tools you already use.