01
Data scattered across too many systems
Claims platforms, clinical repositories, call transcripts, and benchmark files remain disconnected, making a reliable care and cost picture difficult to assemble.
The AI-Native Data Operations Platform for Healthcare
Primeridian Health connects existing healthcare systems, unifies claims, clinical, and operational data, and turns that foundation into automated workflows that lower cost, reduce administrative work, and improve outcomes.
Siloed Systems
Manual Operations
Missed Interventions
Why this matters
02
Teams reconcile context by hand
Analysts and operators spend days cross-checking sources before finance, care management, quality, and reporting teams can act with confidence.
03
High-risk populations surface late
Without unified signals, avoidable episodes, chronic disease escalation, behavioral health needs, and care gaps often appear after the intervention window has narrowed.
04
Point solutions rarely connect
Single-purpose tools may automate a narrow step, but the underlying data layer remains fragmented and hard to query across the organization.
Our approach
Built to work with what you have
A lightweight AI layer connects to the systems already in place, extracts meaning from structured and unstructured inputs, and links everything into a single operational record.
Connect
Agents ingest claims systems, warehouses, clinical records, documents, and external datasets without forcing a migration.
Unify
AI parses notes, transcripts, authorizations, and claims details, then maps diagnoses, risks, and actions back to patient-level context.
Act
Stakeholder-specific workflows identify opportunities, route follow-ups, monitor measures, and keep operations moving continuously.
Every source, one queryable layer
Claims, clinical documentation, care operations, call center records, and population benchmarks connect into one platform for search, workflow, and reporting.
PRIMERIDIAN
Claims
EHR
Care Mgmt
Call Center
Pop Health
Billing
Risk Scores
Nexus AI
One conversation for answers, workflows, and insight
Nexus AI acts like an autonomous operating partner: ask about your data, describe what to build, simulate impact, or generate a chart from a prompt.
Simulations
See the results before you commit.
Model interventions against a target population and compare likely clinical outcomes, cost impact, and operational effort.
Natural Language
Answers in seconds.
Query claims, costs, risk, utilization, and population health with source-backed responses.
Workflow Engine
Describe it. Deploy it.
Tell Nexus AI what you need and it turns the request into a production-ready workflow.
Intelligence
Never miss a change.
Track guidelines, benchmarks, regulations, and market signals that can affect your programs.
Documents
Every document, connected.
Parse clinical notes, claims documents, reports, and summaries into linked patient context.
Visualizations
Ask a question. Get a dashboard.
Create charts, cohort comparisons, and trend analyses while staying in the same conversation.
Revenue Cycle Platform
Clinical billing infrastructure, rebuilt around automation
Primeridian consolidates AI-powered coding, payer integrations, prior authorization, and HIPAA compliance into one deployment-ready platform for modern health systems.
96.4%
Net Collection Rate
+1.8% vs prior period
97.2%
First-Pass Rate
+2.3% vs prior period
28.3
Avg Days in AR
-4.1d vs prior period
91.4%
PA Approval Rate
+3.2% vs prior period
AI Coding Engine
Claude-powered code suggestions with CCI edit checking, payer LCD validation, and modifier logic validated in seconds.
ICD-10-CMCPTHCPCS IICCI EditsNLP
Universal Integration Hub
One adapter per protocol maps HL7 v2, FHIR R4, X12 5010, CSV, SOAP, REST, and files into the canonical model.
HL7 v2FHIR R4X12 EDICSV/SFTP
Payer Intelligence
Per-payer adjudication rules, FHIR CRD prior authorization, denial pattern learning, and AI-generated appeal drafts.
Prior AuthCRDERA 835Auto-Appeal
Canonical Data Model
Thirteen canonical entities connect patients, encounters, claims, labs, payroll, identity, and tenant-specific workflows.
Multi-tenantEMPIFHIRPostgreSQL
Terminology Engine
Ten code systems with annual update lifecycle, CCI edits, fee schedule management, and semantic search.
SNOMED CTLOINCRxNormNDC
Compliance Suite
HIPAA controls, behavioral anomaly rules, immutable audit chain, and business associate agreement lifecycle support.
HIPAASOC 2HITRUSTAudit
ai-coding-assist v2.1LIVE
INPUT -> "75M, anterior STEMI. LHC performed, coronary angio + ventriculography"
DIAGNOSIS primary: I21.09 - STEMI other coronary
DIAGNOSIS secondary: I25.10 - CAD native vessel
PROCEDURE primary: 93458 - LHC + coronary angio
PROCEDURE add-on: 93459 - arterial conduit
confidence: 0.97
cci_valid: true
lcd: L35062 OK
AI Coding
Clinical notes to clean claims in seconds
The coding engine reads clinical documentation and returns validated ICD-10, CPT, and HCPCS codes with CCI edit checking and LCD validation built in.
AI
Sub-2s responseClinical context is parsed and validated immediately.
OK
CCI edit validationBundling conflicts are flagged before claim submission.
LC
LCD and NCD overlayCoverage criteria are checked per payer and per code.
Specialties
20 specialty billing modules
Purpose-built coding workflows with ICD-10 chapter filters, CPT range validation, modifier rules, and payer LCD overlays.
CardiologyI00-I99
OncologyC00-D49
Radiology70010+
OrthopedicsM00-M99
NeurologyG00-G99
EmergencyS00-T88
Primary CareZ00-Z99
PediatricsP00-P96
ObstetricsO00-O9A
PsychiatryF01-F99
DermatologyL00-L99
GastroK00-K95
UrologyN00-N99
OphthalmologyH00-H59
ENTH60-H95
NephrologyN17-N19
PulmonologyJ00-J99
RheumatologyM05-M36
EndocrinologyE00-E89
HematologyD50-D89
Integrations
Every protocol. Every connection.
One adapter per protocol lets teams add EMRs and payers without touching upstream services.
Full value-chain interoperability web
Healthcare operations move through patient access, clinical work, billing, payer exchange, compliance, and analytics. Primeridian links each step through the standards that already run the ecosystem.
Primeridian Health
Interoperability Fabric
Every standard maps into one auditable operating model for revenue-cycle automation.
CanonicalAI CodingPayer IntelAudit
Active Value Chain Link
Patient access starts the revenue cycle
Scheduling, demographics, eligibility, benefits, consent, coverage discovery, and identity matching enter through FHIR, HL7 SIU/ADT, X12 270/271, USCDI, SMART, and payer APIs.
Primeridian Interoperability Fabric
Normalize standards into canonical patient, coverage, claim, order, observation, document, audit, and identity records.
Clinical Exchange & API Standards
Bedside, app, population, decision-support, and longitudinal record exchange.
Claims, Payer & Administrative Standards
Eligibility, claims, remittance, enrollment, authorization, attachments, and operating rules.
Terminology, Pharmacy & Lab Standards
Code systems, units, medications, vaccines, labs, procedures, diagnoses, and pharmacy transactions.
Imaging, Documents & Exchange Profiles
Imaging, document sharing, patient identity, provider directory, audit, and cross-community exchange.
Trust, Identity, Quality & Public Health
Authentication, authorization, trusted exchange, quality reporting, public health reporting, and national networks.
Selected Standard
HL7 FHIR R4/R5
Modern RESTful healthcare resource exchange for patient, coverage, claim, observation, medication, encounter, and workflow data.
Primeridian Maps
- US Core, Da Vinci, Bulk Data, subscriptions
- Canonical patient, coverage, claim, observation, and audit records
Universal Protocol Layer
Clinical, payer, file, and legacy exchange normalized into one canonical model.
HL7FHIRX12CSVSOAP
REST & EventsREST APIs, CDS Hooks, webhooks, payer portals
EHR SourcesEpic, Oracle Health, athenahealth, Meditech
Payer Exchange837, 835, 270/271, 276/277, 278, 999
Legacy FilesTXT, fixed-width, pipe-delimited, SFTP drops
athenahealthMeditechAllscriptseClinicalWorksNextGenDrChronoPractice FusionGreenway HealthAny HL7 / FHIR Source
Compliance & Security
Gold-standard healthcare security
Enterprise compliance built in, not bolted on. PHI encrypted, access audited, and anomalies detected in real time.
HIPAA Compliant
Administrative, technical, and physical safeguards for healthcare operations.
- Privacy Rule - minimum necessary
- Security Rule controls
- Breach notification workflow
- BAA lifecycle management
- Behavioral monitoring rules
SOC 2 Type II Ready
Trust Services Criteria coverage for security, availability, and confidentiality.
- Logical access controls
- Continuous monitoring
- Change management
- Backup and DR testing
- Evidence automation
HITRUST CSF v11
Enterprise readiness for health systems and payer organizations.
- Access control mapping
- Communications security
- NIST 800-53 cross-mapping
- ISO 27001 alignment
- Annual penetration testing
Real-time behavioral anomaly detection
Active rules detect VIP record access, employee snooping, no-care-relationship access, after-hours PHI, bulk extraction, break-glass usage, brute force events, service account logins, and audit log review.
VIP AccessEmployee RecordsNo Care RelationshipAfter-HoursBulk ExtractionBreak-GlassBrute ForceAudit Log Viewed
Pricing
Transparent pricing. No surprises.
Every plan includes the complete platform, HIPAA compliance, and dedicated implementation support.
Practice
Independent practices and small specialty groups up to 10 providers.
$2,400 / month
- All 20 specialty billing modules
- AI coding assistant
- Medicare + 2 commercial payers
- Real-time eligibility
- HIPAA compliance suite
Health System
Multi-specialty groups and regional health systems up to 100 providers.
$9,800 / month
- Everything in Practice
- All 7 major payer integrations
- Custom EMR interface
- Prior auth automation via CRD
- Denial prediction + auto-appeal
- SOC 2 Type II audit pack
Health Network
Large IDNs and multi-hospital networks with unlimited providers and custom SLA.
Custom
- Everything in Professional
- Unlimited EMR interfaces
- All payers + Medicaid
- HITRUST CSF readiness
- 99.9% SLA guarantee
- 24/7 support + CSM
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.