Evidence-based member insights delivered in provider workflows reduce provider abrasion and enhance care gap closure

GLENDALE, Calif. – September 20, 2023 – Reveleer, a leading healthcare technology workflow and analytics company committed to advancing value-based care, today announced the extension of its Prospective Risk Adjustment and Quality Improvement solution suites to risk-bearing providers. Reveleer empowers providers with highly reliable suspected diagnoses pre-encounter and at the point of care. Clinician agreement rates exceed 70% for more informed care decisions, accurate reflection of patient risk profiles and closed gaps in care. Designed to ease healthcare providers' administrative burden, the Prospective Risk Adjustment solution delivers timely, evidence-based clinical insights that directly impact member outcomes. Seamless delivery of the patient summary in existing provider processes and systems improves provider adoption and streamlines pre- and post-encounter workflows.

“We give payers and risk-bearing providers a unique 360-degree view of member risk, transforming risk adjustment and quality improvement into a proactive, strategic capability to enhance member care and health,” said Jay Ackerman, CEO. “We use proprietary AI to synthesize data from rich claims and clinical sources and quickly deliver accurate, actionable insights directly to clinicians as they care for patients. This represents a significant paradigm shift for value-based care."

Payers and providers face increasing pressure to create complete, clinically substantiated member risk profiles. The volume of requests and lack of information about care gaps at the point of care hinders a holistic and precise view of the patient. The Reveleer platform makes Prospective Risk Adjustment and Quality Improvement viable at scale due to the breadth and depth of its claims and clinical data ingestion capabilities and the speed and accuracy of its AI. Key features include:

  • Access to a nationwide network of claims and clinical data sources: The Reveleer platform aggregates structured and unstructured patient data from over 45 electronic health record systems (EHRs) and 75+ national and regional health information exchanges (HIEs) as well as community providers, specialists, labs, prescriptions, and more.
  • Concise patient-risk insights delivered pre-encounter: The patient summary synthesizes and prioritizes suspected diagnoses with links to clinical source documentation to inform clinical decisions, risk assessment and quality review. The patient summary is delivered through a bi-directional EHR-agnostic API integration, reducing chart review time to an average of 2.3 minutes and making care gap closure actionable at the point of care.
  • AI-assisted physician documentation: The AI-powered clinical assisted documentation tool helps physicians document patient encounters quickly and accurately, leveraging a content library with over 1.3 million synonyms, acronyms, and abbreviations mapped to industry standards. Clinicians can efficiently document assessments and care plans to improve downstream data accuracy while reducing administrative burden, allowing clinicians to focus on patient care.

Reveleer's Prospective Risk Adjustment and Quality Improvement solution suites are currently deployed across several national providers, delivering measurable ROI and directly enhancing the quality of care for all members and patients. Backed by recent capital investments, Reveleer continues its momentum to expand its Risk Adjustment, Quality Improvement, and Member Management solutions for payers and providers, delivering the market's most comprehensive workflow, data, and analytics offering.


Janet Mordecai

Amendola Communications (for Reveleer)


About The Author

Reveleer is a healthcare-focused, technology-driven workflow, data, and analytics company that uses natural language processing (NLP) and artificial intelligence (AI) to empower health plans and risk-bearing providers with control over their Quality Improvement, Risk Adjustment, and Member Management programs. With one transformative solution, the Reveleer platform allows plans to independently execute and manage every aspect of enrollment, provider outreach, data retrieval, coding, abstraction, reporting, and submissions. Leveraging proprietary technology, robust data sets, and subject matter expertise, Reveleer provides complete record retrieval and review services, so health plans can confidently plan and execute programs that deliver more value and improved outcomes. To learn more about Reveleer, please visit Reveleer.com.