Certifications

Using PROMETHEUS Analytics®

The PROMETHEUS Analytics can be used for multiple purposes, ranging from supporting claims processing activities tied to bundled payment programs, all the way to calculating budgets for PROMETHEUS Payment implementations, and more generally evaluating the effectiveness and efficiency of providers.

To benefit from the full power of the PROMETHEUS Analytics, we encourage you to reach out to one of our Certified Partners.

There are three types of certification that our partners can achieve, each reflecting a specific use of/purpose for the Analytics:

Claims Processing Certification – This certification focuses on the basics of bucketing claims into bundles and differentiating claims that are associated with typical services from those that are attributable to potentially avoidable complications.

Claims and Provider Analysis Certification – This certification focuses on the use of the PROMETHEUS Analytics to sift through historical claims data and create severity-adjusted comparisons of episode costs attributed to providers. Thanks to the unique algorithms that split costs between typical and complications, providers can be compared based on the affordability and quality of the care they provide, adjusted for the severity of their patients. In addition, unique insights can be generated by looking at the effect of managing patients across a continuum of care, including the use of relevant procedures.

PROMETHEUS Payment Implementations Certification – This certification focuses on the ability to fully implement the PROMETHEUS Payment model, including the creation of severity-adjusted prospective budgets for episodes of care, and the reconciliation of those budgets to actual costs incurred.

For more information on each of the many features of the episode system, review the Core Components of PROMETHEUS Analytics.

 

PROMETHEUS Analytics Certified Partners

Claims and Provider Analysis Certification:

Version 5.5

Aver


Version 5.5

Change Healthcare


Claims Processing Certification:

Version 5.5

Episode Analytics to Guide Your Value-Based Care Transition

A value-based payments analytics platform designed for health plans that want to foster deep clinical and cost analysis through episodic claim grouping and network analysis.

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