Reveleer for HEDIS® Medical Record Review

Most HEDIS® Medical Record Review (MRR) projects are dreaded, logistical nightmares, and often ill-executed initiatives. In the past, this part of HEDIS® was often handled in a ‘let’s just get it over with’ type attitude. Many vendors had varied results and consequences were not severe.

That is changing. Driven by fundamental shifts in the provider landscape (ACOs, medical homes, EMRs) to state and federal government programs (STAR Ratings, ICD10, HIEs), HEDIS® MRR is quickly rising in strategic importance.

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Reveleer efficiently works with providers to retrieve every relevant medical record possible, abstract them correctly, and deliver the results reliably back to the health plan or vendor to maximize HEDIS® rates for hybrid measures. This approach allows the health plan to strategize, oversee progress, and resolve any provider or data issues that may impact results. Reveleer provides the process, the technology and, in many cases, some or all of the project team.

Reveleer's best practices have personnel start working with clients well ahead of the HEDIS® season. Planning, benchmark setting, data strategy, integration work, project logistics, configuration, and setup are done well ahead of loading data, which results in more accurate data collection and analysis. Aggressive timelines, weekly guaranteed benchmarks, and guaranteed project completion weeks ahead of the submission deadline leaves room for analysis, additional rate maximization actions, and timely submission of excellent results to HEDIS® certified auditors and the NCQA.