Complete Provider Data Management for Health Plans and Health Systems

PRIME® by Atlas Systems manages every stage of the provider data lifecycle from credentialing and enrollment through directory validation and continuous compliance monitoring.

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Trusted by Global Leaders

Where Provider Data Usually Goes Wrong

Stale Rosters

Provider data changes at a rate of 25% every 90 days. Most organizations catch those changes weeks too late, long after the directory has already gone wrong.

Revenue Leakage

Claim denials tied to provider data mismatches cost health systems and health plans millions each year. The error happens upstream. The revenue impact lands downstream.

Regulatory Exposure

CMS, NCQA, and the REAL Health Providers Act now require continuous, documented verification of provider records. Annual spot checks are no longer sufficient.

One Platform for Every Stage of the Provider Data Lifecycle

PRIME® manages provider data from credentialing and payer enrollment through directory validation and continuous monitoring on one integrated platform. Organizations across health plans, health systems, behavioral health, and managed care use it to maintain compliant networks, reduce audit risk, and eliminate the administrative overhead that comes with managing provider data across disconnected systems.

Provider records from every system your organization uses is consolidated, validated, and current.

Credentialing, enrollment, validation, and monitoring work together without reconciling separate tools or losing data between stages.

Continuous monitoring ensures your network data is accurate whenever a regulator asks, not just when a review cycle is scheduled.

The Modules That Run Your Provider Data Operations

Six capabilities built to work together, covering every stage of the provider data lifecycle.

Provider Data Management Engine

Provider records from every source your organization relies on, including EHRs, credentialing platforms, billing systems, and payer portals, consolidated into one governed dataset with automated change detection and accuracy tracking.

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Provider Directory Data Validation

Direct outreach to every provider in your network through a six-step verification framework, confirming demographic data, specialty, location, and affiliation status at the source.

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Provider Credentialing

Primary source verification, document management, and re-credentialing workflows structured to keep pace with network growth without adding to your team's manual workload.

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Payer Enrollment

Non-delegated enrollment managed from application through approval, with status tracking, automated follow-up, and verified provider records at every submission stage.

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Continuous Monitoring

License expirations, sanction updates, exclusion list changes, and demographic shifts tracked across your entire network and flagged before they create billing errors or compliance exposure.

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Provider-Payer Roster Management

Automated roster submission and reconciliation, formatted to each payer's specifications, with continuous comparison against prior submissions and full payer performance tracking by plan.

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Beyond the Platform: Services That Handle It for You

Some organizations need software. Others need an operational partner to run the work entirely. PRIME® offers both.

Provider Directory Services

Print-Ready and Hosted Provider Directories

We manage the full provider directory lifecycle on your behalf, from primary-source outreach and data validation to ADA-compliant, CMS-ready printed and digital directory production. Your team sets the standards. We handle the execution.

Direct provider outreach using the six-layer validation framework
Print-ready, ADA-compliant directories delivered to CMS specifications
Ongoing update cycles with full audit documentation

Ad Hoc Services

Surveys and Audits

PRIME® conducts regulatory audits and CMS-mandated surveys so your team knows exactly where your network stands before a regulator asks the same question.

CMS Appointment Wait Time surveys using secret shopper methodology
Mock CMS and state regulatory audits with remediation support
Network adequacy reviews and delegation oversight audits

Winner of 2025 “Best Provider Data Management Platform”Award by MedTech Breakthrough

Distinguished Vendor” in Gartner's Hype Cycle for US Healthcare Payers 2024

Major Player in IDC MarketScape for U.S. Provider Data Management for Payers 2025-2026 Vendor Assessment

Built for Enterprise Healthcare Standards

FHIR-Compatible Platform

Real-time data exchange across all connected systems

ISO and SOC 2 Certified

Enterprise-grade security and data protection standards

Microsoft Azure Hosted

Scalable, reliable cloud infrastructure for healthcare data

NCQA-Aligned Workflows

Credentialing and compliance built to NCQA requirements

We have used PRIME® to validate our provider data and the accuracy level has moved up to 98%, which is unheard of. The biggest differentiator in PRIME® is their primary data verification model, which means they reach out to every single provider.”

- Provider Data Quality Leader, Leading NY Health Plan