Medical Record Reviews can be effectively managed by increasing productivity through automation and project organization. 

The Reveleer Platform improves the ease and security of handling, accessing and analyzing medical records. Health Plans can manage cost and productivity by running medical record review projects on our platform. 

Copy of Provider Outreach

 

How does the Reveleer platform make the process of provider outreach easier? 

This is just a brief preview of the features that Reveleer offers:

1. The platform has a built-in function that makes outbound calls to providers with a click.

2. In the overview page of provider outreach projects, a manager, lead, or administrative role can see a high-level summary of chase counts and offices, assignment lists, and other fields.

3. There is the ability to filter lists by such parameters as status, project, a specific Address Identification, IDs assigned to a specific employee, and more. The platform eliminates the tedious manual work of splitting up address lists or updating excel sheets by assignee, contact information or project status.

4. Address IDs can be tied to together, and a health plan can use our platform to group together disparate IDs with hundreds of locations that may be used as a single record retrieval point.

5. A “get next” feature which produces the next Address ID to call and a button to complete the call function, based on importance or specific rules a platform user sets forth.

6. The function to have very specific users assigned to Address IDs, grouped together by fields such as county, area, or other category. When the employee logs in, they are able to see their assignments in an organized list.

7. A health plan can move chases from Address ID to Address ID within the platform, which is key when doctors move locations and records follow.


What is an essential component to completing medical review projects? 

One of the biggest deals and key issues of any project are the Pends – who is working them, how timely they are, how to organize and work them, how we communicate through them, and the rules of communication.  

The Reveleer platform tracks these Pends through its own Pend project center: 

  • The platform automatically updates the status of a project when a provider has not sent over records by a commit date (entered by a platform user– the status changes from incomplete, to resolved, past due, etc. 
  • Pend IDs are clickable, leading to a Pend summary page, which reveals the reason of the Pend, with its own reporting and who needs to handle the outstanding issue. The breakdown includes who “owns” the problem – whether the medical office or health plan needs to resolve the issue. 

Address IDs shown with the Status and Pends, Pend Status, and other important info: 

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Pend IDs are clickable and leads to a page with full details:

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How should a Health Plan organize information to lead to project success?

An important part in the success of medical review projects is project tracking and organization. The platform was thoughtfully designed to have essential information laid out and organized into tabs that further break down project status and outstanding tasks. This makes it easier to map out the next steps and close out lists. 

  • An important hub accessed in the platform is the Address ID page which includes a few main tabs, or dedicated pages such as: 
  • Address info  
    • This summary at-a-glance includes contact address and information, group name, last contact, and other essential stats 
    • Providers at the site address – showing providers with active chases, updated as projects or needs change and evolve over time 
    • Chase grid – First and last name of patient, pend status, Provider name, commit to receive record date, etc. 
    • Address Timeline – quick overview of every activity that has happened at this site 
  • Contact History 
    • Tracks emails, phone calls, and faxes to the location 
    • Notes related to the call 

 

 

 

 

 

 

 

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.