What is actually inside PROMETHEUS.
Not a dashboard bolted onto an export. A data substrate, three engines that run against it, and the working surfaces your revenue, compliance and clinical teams each need.
The data substrate
PROMETHEUS is only as good as what it can see. It reads from the systems your program already feeds, rather than asking you to assemble a new one.
| Source | What it contributes | Access |
|---|---|---|
| Encounter & claim data | Professional, institutional and pharmacy encounters, diagnosis history, provider references — the record CMS is actually scoring. | Read-only, tenant-scoped |
| Submission acknowledgements | EDS and RAPS responses, MAO-002 and MAO-004 files: what CMS accepted, what it rejected, and what it never acknowledged at all. | Read-only |
| Enrollment & capitation | Member roster and monthly membership / capitation detail, so revenue figures reconcile to what you were actually paid. | Read-only |
| Community clinical data | TEFCA / HIE / QHIN records for care delivered outside your four walls — evidence for conditions your own encounters never saw. | Query, consent-governed |
Tenant scoping is enforced three times, not once. The service account is restricted to a read-only role; every query is parameterized with the tenant identifier; and the tenant is resolved from the authenticated user's own token rather than from anything the browser sends. One PACE organization cannot see another's data — and that is verified by automated test, not by policy.
Three engines, running together
Each answers a different question. They run concurrently against the same substrate, so the three answers are always as of the same moment.
Recapture
Which conditions are supported by evidence but missing from the data CMS scored — and what each one is worth. Produces the gap registry, ranked by revenue with days-open aging.
Encounter quality
Which submissions were accepted, rejected, or never acknowledged; which rejection codes cluster; and which provider or workflow is generating them. Produces the pipeline view and the EQS score.
RAF & capitation
What your risk score is, where it is trending, and what that means in dollars under your own PMPM assumption — calibrated to the PACE risk-model blend and frailty adjustment.
The surfaces people actually work in
Seven dashboard views, plus the deeper registries. Daily Pulse is the default; the rest are one click away.
Action worklist
The single most useful screen in the product: what to do today, in priority order, with the dollars attached. Assignment, aging and closure are tracked in the same place, so "we're working the gaps" becomes a number instead of an assertion.
- Prioritized by revenue impact and time remaining
- Owner and status on every item
- Closure feeds straight back into the RAF forecast
Synthetic demonstration data — no real participant information.
Risk intelligence and member RAF
Member-level risk detail behind every aggregate: which HCCs are driving the score, which are at risk of dropping, and which members carry the most exposure if documentation lapses.
- Member RAF, HCC composition and interaction terms
- Provider scorecards — who documents completely and who doesn't
- Methodology tab exposing every coefficient and assumption in use
Synthetic demonstration data — no real participant information.
Daily Pulse
Executive KPIs recalculated against current data — gaps, revenue at risk, average RAF, acceptance rate, encounter quality score and annual capitation.
Submission pipeline
Every batch from generation through CMS acknowledgement, with rejection reasons grouped by cause rather than listed by the thousand.
RAF forecast
Twelve-month trajectory under continue / accelerate / decelerate scenarios, with the upside and the exposure both expressed in dollars.
Live stream
Events as they happen — submissions, acknowledgements, gap closures — so the operations team is not waiting on a nightly report.
Peer benchmarks
Quartile comparison against a cohort of similarly sized PACE plans. Anonymized; individual peer values are never exposed.
External evidence
Community clinical records that support a condition your own encounters never captured, surfaced next to the gap they resolve.
The part most vendors don't show you
Software that touches revenue has to be operable. PROMETHEUS ships the monitoring and diagnostics layer as a product surface, not as an internal tool.
Operations center
Per-organization health scoring over time, alert rules with routing and escalation, data-freshness monitoring and a named analyst assignment — so a stalled feed is noticed by us before it is noticed by you.
Diagnostics & error codes
Every failure carries a structured code across eleven domains, with a customer-facing error card that explains what happened and what to do. Support can search failures, detect clusters across organizations, replay a job with its original parameters, and read a timeline of exactly where it spent its time.
Generate, don't submit. PROMETHEUS produces submission-ready output and holds it. Transmission to CMS is a separate, explicit action, taken by a person, in a mode that has to be deliberately enabled — and every transmission is individually audited. The software never quietly files something on your behalf.
Best understood by driving it.
Thirty minutes on a live synthetic PACE dataset, with your questions rather than our script.