Health Plans

Managing the demands of members, providers & regulators

The Industry

As members, regulators, and health systems make growing demands on payers, they often find themselves short on key resources and systems. Health plans need to carefully collect and store terabytes of precious data on millions of members and providers – at a time when demands for access and the threat of cyberattacks are often competing. Health plans also tend to absorb the blame for troubles that originate elsewhere – and relevant solutions are seemingly hard to come by.

Provider data is a crucial component of healthcare system success – as well as a constant burden for health plans to maintain. PRIME® — a platform from Atlas Systems — solves the provider lifecycle challenge with a rigorous, proven approach that incorporates provider data validation, ongoing monitoring, provider training, and more to drive compliance and improved member satisfaction.

Problems Atlas solves

Provider data accuracy

Atlas takes a gold-standard approach to provider data validation, achieving best-in-class data accuracy with 95% client-audited quality assurance and up to 90% validation success.

Member complaints & regulatory compliance

Accurate provider data makes sure that members get connected to the right doctors – and keeps regulators at bay

CMS’s Appointment Wait Time requirements

Qualified Health Plans (QHPs) will need to measure and report appointment wait times, using an independent third- party, for various products and markets beginning January 2025. Turn to Atlas for help.

Provider Directory Compliance

Atlas delivers & fulfills instant, high-quality, ADA-compliant versions of your directory on paper or in PDF

Ongoing Monitoring

Leveraging the Limited Access Death Master File and other key resources, PRIME helps you keep your listings accurate and complete, with no hassles or worries

Provider Training

We deliver state-of-the-art technology to provide a positive, structured, and fully customizable training experience that ensures that providers in your network are fully trained for delivering quality care.

Success story

Key New York health plan relies on PRIME to manage provider data quality
A leading New York-based provider of primary and specialty care and wellness solutions to millions of people in the New York area needed help managing its health provider directory. Atlas PRIME delivered a combination of technological innovation and strategically grounded expertise, as well as highly trained staff to conduct direct provider outreach. The result: Verified provider data with completeness, timeliness, and quality.

Atlas client speaks

“PRIME scored 100% on a recent quality audit of our provider data accuracy. We’ve been impressed by their quality scores and dedication to providing the most accurate provider data possible. PRIME has increased our provider directory accuracy and enhanced member experience.”

Operational leader

Northeastern health plan