PlatformSpecialtiesIntegrationsCompliancePricing
Enterprise Revenue Cycle Platform

Clinical billing
infrastructure
built to win.

Primeridian consolidates AI-powered coding, payer integrations, prior authorization, and HIPAA compliance into one deployment-ready platform — engineered to replace legacy RCM at scale.

All systems operational
HIPAA compliant
SOC 2 Type II
HL7 certified
HITRUST CSF v11
Live Platform Metrics
Net Collection Rate
96.4%+1.8%
First-Pass Rate
97.2%+2.3%
Avg Days in AR
28.3−4.1d
Denial Rate
4.7%−0.9%
PA Approval Rate
91.4%+3.2%
Net Collection Rate96.4%
Avg Days to Code4.7d
First-Pass Rate97.2%
Avg AR Days28.3
Denial Rate4.7%
PA Approval Rate91.4%
Payers Integrated47+
Specialty Modules20
Code Systems10
HIPAA Controls Active14
Net Collection Rate96.4%
Avg Days to Code4.7d
First-Pass Rate97.2%
Avg AR Days28.3
Denial Rate4.7%
PA Approval Rate91.4%
Payers Integrated47+
Specialty Modules20
Code Systems10
HIPAA Controls Active14
Platform

Revenue cycle,
fully automated

From patient intake to final remittance — every workflow driven by AI, every protocol supported, every payer covered.

⚡
AI Coding Engine
Claude-powered code suggestions with CCI edit checking, payer LCD validation, and modifier logic — validated in under 2 seconds.
ICD-10-CMCPTHCPCS IICCI EditsNLP
Learn more →
⇄
Universal Integration Hub
One adapter per protocol. HL7 v2, FHIR R4, X12 5010, CSV, SOAP, and REST all map to the canonical data model.
HL7 v2FHIR R4X12 EDICSV/SFTP+3
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◈
Payer Intelligence
Per-payer adjudication rules, FHIR CRD prior auth, denial pattern learning, and AI-generated appeal letters.
Prior AuthCRDERA 835Auto-Appeal7+
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◑
Canonical Data Model
13 canonical entities for patients, encounters, claims, labs, payroll, and identity across all tenant types.
Multi-tenantEMPIFHIRPostgreSQLLTREE
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◎
Terminology Engine
10 code systems with annual update lifecycle, CCI edits, fee schedule management, and pgvector semantic search.
SNOMED CTLOINCRxNormNDC10 Systems
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⊠
Compliance Suite
HIPAA controls with 10 behavioral anomaly rules, immutable SHA-256 audit chain, BAA lifecycle management.
HIPAASOC 2 Type IIHITRUSTBAAAudit
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Specialties

20 specialty
billing modules

Purpose-built coding workflows with ICD-10 chapter filters, CPT range validation, modifier rules, and payer LCD overlays.

♥
Cardiology
I00–I99
⊕
Oncology
C00–D49
◎
Radiology
70010+
⊞
Orthopedics
M00–M99
⌬
Neurology
G00–G99
✚
Emergency
S00–T88
⌂
Primary Care
Z00–Z99
◈
Pediatrics
P00–P96
◑
Obstetrics
O00–O9A
◐
Psychiatry
F01–F99
◍
Dermatology
L00–L99
◉
Gastro
K00–K95
◎
Urology
N00–N99
◌
Ophthalmology
H00–H59
◫
ENT
H60–H95
◎
Nephrology
N17–N19
◎
Pulmonology
J00–J99
✦
Rheumatology
M05–M36
◎
Endocrinology
E00–E89
◈
Hematology
D50–D89
ai-coding-assist v2.1
LIVE
# clinical documentation input

INPUT →
"75M, anterior STEMI. LHC performed,
coronary angio + ventriculography"

# processing: 1.2s · ICD-10 2024

DIAGNOSIS
primary : I21.09 — STEMI other coronary
secondary: I25.10 — CAD native vessel
PROCEDURE
primary : 93458 — LHC + coronary angio
add_on : 93459 — arterial conduit
confidence: 0.97
cci_valid: true
lcd: L35062 ✓
modifier: none
✓Ready · Medicare Part B
AI Coding

Clinical notes to
clean claims in seconds

Claude-powered coding engine reads clinical documentation and returns validated ICD-10, CPT, and HCPCS codes with CCI edit checking and LCD validation built in.

⚡
Sub-2s response
Clinical context parsed and validated immediately
◎
CCI edit validation
Bundling conflicts flagged before submission
◈
LCD / NCD overlay
Coverage criteria checked per payer, per code
✓
97%+ first-pass rate
Validated against 10 active code systems
Integrations

Every protocol.
Every connection.

One adapter per protocol. Add new EMRs and payers without touching upstream services.

HL7
HL7 v2 / v3
ADT, ORU, SIU, ORM, DFT
FHIR
FHIR R4
Patient, Coverage, Claim, Observation
X12
X12 5010
837P/I, 835, 270/271, 278, 999
CSV
CSV / SFTP
Demographics, eligibility, lab data
SOAP
SOAP / WSDL
Legacy payer web services
REST
REST APIs
Payer portals, clearinghouses, EMRs
TXT
Flat Files
Fixed-width, pipe-delimited formats
CDS
CDS Hooks
Real-time coverage determination
Certified EMR / EHR Integrations
Epic
Oracle Health (Cerner)
athenahealth
Meditech
Allscripts
eClinicalWorks
NextGen
DrChrono
Practice Fusion
Greenway Health
+ Any HL7 / FHIR Source
Compliance & Security

Gold-standard
healthcare security

Enterprise compliance built in, not bolted on. PHI encrypted, access audited, anomalies detected in real time.

HIPAA
HIPAA Compliant
Full administrative, technical, and physical safeguards per 45 CFR §164.
  • ✓Privacy Rule — minimum necessary
  • ✓Security Rule — §164.312 controls
  • ✓Breach notification — 60-day clock
  • ✓BAA lifecycle management
  • ✓10 behavioral monitoring rules
SOC 2
SOC 2 Type II Ready
Trust Services Criteria: Security, Availability, Confidentiality.
  • ✓CC6.1 Logical access controls
  • ✓CC7.2 Continuous monitoring
  • ✓CC8.1 Change management
  • ✓A1.2 Backup & DR tested
  • ✓Annual evidence automation
HITRUST
HITRUST CSF v11
The gold standard demanded by enterprise health systems and payers.
  • ✓01: Access control (28 controls)
  • ✓09: Communications security
  • ✓NIST 800-53 cross-mapping
  • ✓ISO 27001 alignment
  • ✓Annual penetration testing
⚠
Real-time behavioral anomaly detection
10 active rules detect VIP record access, employee snooping, no-care-relationship access, after-hours PHI, bulk extraction, break-glass usage — with automatic investigation creation and privacy officer alerting.
VIP AccessEmployee RecordsNo Care RelationshipAfter-HoursBulk ExtractionBreak-GlassBrute ForceService Account LoginAudit Log Viewed
Performance

Precision at enterprise scale

0.0%
Net Collection Rate
↑1.8%vs prior period
0.0d
Avg Days to Code
↑2.1dvs prior period
0.0
Avg Days in AR
↑4.1dvs prior period
0%
First-Pass Rate
↑2.3%vs prior period
Pricing

Transparent pricing.
No surprises.

Every plan includes the complete platform, HIPAA compliance, and dedicated implementation support.

Starter
Practice
Independent practices and small specialty groups up to 10 providers.
$2,400
/ month · up to 10 providers
  • ✓All 20 specialty billing modules
  • ✓AI coding assistant
  • ✓Medicare + 2 commercial payers
  • ✓Real-time eligibility
  • ✓HIPAA compliance suite
  • —Custom EMR interfaces
  • —HITRUST package
Professional
Popular
Health System
Multi-specialty groups and regional health systems up to 100 providers.
$9,800
/ month · up to 100 providers
  • ✓Everything in Practice
  • ✓All 7 major payer integrations
  • ✓Custom EMR interface (1 source)
  • ✓Prior auth automation via CRD
  • ✓Denial prediction + auto-appeal
  • ✓SOC 2 Type II audit pack
  • ✓Dedicated implementation PM
Enterprise
Health Network
Large IDNs and multi-hospital networks. Unlimited providers, custom SLA.
Custom
volume-based, annual contract
  • ✓Everything in Professional
  • ✓Unlimited EMR interfaces
  • ✓All payers + Medicaid
  • ✓HITRUST CSF readiness
  • ✓99.9% SLA guarantee
  • ✓On-site implementation team
  • ✓24/7 support + CSM
Get started

Set the standard for your
revenue cycle

Join health systems replacing legacy billing infrastructure with Primeridian's AI-native platform. Implementation in as few as 6 weeks.

No commitment required
HIPAA-secure demo environment
6-week implementation path