Solutions · Policy, network, and utilization management teams
See your policiesthe way providers do.
Prisym lets payer teams benchmark their coverage positions against peers, catch inconsistencies across lines of business and states, and confirm that delegated vendors apply what the plan intends.
Your policies are read by thousands of providers.Read them the same way.
For payers
What payers teams use Prisym for.
- 01
Peer benchmarking
Compare your criteria for a therapy against other plans and government programs in one matrix.
- 02
Consistency across the enterprise
Surface differences between states, lines of business, and delegated entities on the same therapy.
- 03
Vendor alignment monitoring
Confirm what your delegated vendors are actually applying against your own policy, and when it changed.
1,200+
Organizations in the coverage catalog
Every
Version retained for audit
API
Coverage and change data for internal tools
In practice
A delegated vendor's criteria differ from the plan's own policy
- 1
Both policies are in the library, matched to the same therapy.
- 2
The matrix shows the conflict; the diff shows exactly where the criteria diverge.
The policy team resolves it before providers find it in a denial.
The platform underneath
Every solution runs on the same library.
One index of payer policies, versioned forever, feeds the matrix, the alerts, and every determination.
Ready to benchmark your coverage positions?
Pick a therapy. We will show you where your criteria sit against the market.