Reveleer introduces its Provider Impact Score to customers, which marks the first national assessment of U.S. medical providers’ willingness to provide accurate, complete and timely medical records in response to government health plan requirements. 

Provider-Impact-Score-Blog-Preview-Image“With the launch of the Provider Impact Score we now have a tool that can be used to track what medical providers are doing to help their health plans efficiently retrieve charts that support Risk Adjustment, Quality Improvement/HEDIS® and IVA audits,” said Rita Young, Chief Operating Officer.  

Rita continued: “The Provider Impact Score is unique in that it leverages the millions of dynamic data points that Reveleer captures throughout the process of engaging with a health plan’s provider network in pursuit of medical records. We then run these data points through a proprietary algorithm that scores providers across multiple categories, including speed of response to chart requests, number of times we requested charts before receiving them, and what retrieval methodology they used.” 

According to the Provider Impact Report, provider locations with a low rank and score sent Reveleer the fewest charts out of those requested. In contrast, provider locations with a higher rank and score are engaged in the chart collection process and have stronger commitments and practices. For HEDIS 2018, the first season that Reveleer evaluated, the average Provider Score across all health plans is 59.81. The highest performing health plan had an average Provider Score of 65.18 across their provider network. 

“We are proud that Reveleer recognized an opportunity to improve our ability to meet customer chart retrieval commitments,” said Jay Ackerman, CEO. “As a business, our growth strategy is driven by a deep focus on how to help health plans to more efficiently utilize their provider network for record retrieval, while simultaneously lowering provider friction with the process. We will continue to seek areas where we can further evolve and strengthen our approach. The end-of-project Provider Impact Report can help plans with proactively targeting and building better relationships with lackluster provider offices.

About The Author

Reveleer is a healthcare software and services company that empowers payers in all lines of business to take control over their risk adjustment and quality improvement programs. The Reveleer platform enables payers to independently execute and manage every aspect of provider outreach, retrieval, coding, abstraction and reporting – all under one single platform. Leveraging its technology, proprietary data sets, and subject matter expertise, Reveleer also assists payers with full record retrieval and review services to support financial performance and improved member outcomes.