Driving financial results and measurable outcomes for payers
The Reveleer Platform
Accelerate value-based care outcomes with AI
Improve accuracy and the predictive power of your data with purpose-built AI healthcare solutions
A stronger foundation for risk and quality programs
Health plans today face rising regulatory scrutiny, shifting payment models, and increasing pressure to deliver measurable outcomes. Reveleer helps payers meet these challenges with a platform that unifies risk and quality programs, streamlines data, and reduces audit exposure. With AI-driven automation, payers can shift from reactive processes to proactive strategies that protect revenue and support better health outcomes for members.
How AI-powered risk adjustment tripled coding speed
A large regional health plan needed to scale its risk adjustment programming as its Medicare Advantage business grew. It used Reveleer’s Risk Adjustment suite to help code 1.2 million charts in 4 months, tripling its coding speed.
1.2 million charts
To quickly analyze a high volume of charts, the health plan leveraged Reveleer’s Evidence Validation Engine (EVE™) to pinpoint the most relevant evidence for each case.
40% increase in value per chart
EVE™ assisted the plan’s coders by validating existing diagnoses and uncovering potential missed conditions, significantly increasing the value of each chart.
30% more efficient workflows
Reveleer’s Risk Adjustment suite facilitated collaboration among the plan’s coding teams and saved countless hours of time previously spent manually reviewing each chart.
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Why leading payer organizations choose Reveleer
Engineered for payer simplicity
Purpose-built for payers, Reveleer eliminates complexity by bringing risk, quality, and member management together in one platform. Payers get streamlined workflows, less manual effort, and faster results.
Automated data ingestion and retrieval
Reveleer's AI and NLP (Natural Language Processing) extract data from various sources, building a comprehensive member view and eliminating the need for manual data entry.
Accelerated coding and abstraction
Our AI-powered Evidence Validation Engine, EVETM, accelerates coding workflows to minimize errors and improve efficiency. This means fast and accurate clinical review
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HCC optimization made smarter with AI-powered retrospective risk adjustment
For health plans and providers, effective retrospective risk adjustment is key to success in value-based care. Accurate, efficient programs support fair reimbursement, high-quality care, and financial sustainability. With AI, organizations can drive targeted HCC optimization and improve financial, clinical, and compliance outcomes.
Solutions that move healthcare forward
intelligence
Surface potential diagnosis gaps to providers in care by tapping a nationwide network of clinical data to deliver a longitudinal patient compendium delivered pre-encounter in provider workflows.
Patient insights at the point of care.
Learn More →management
Gain a holistic view of your members with centralized data and efficient enrollment processes, reducing administrative burden and improving overall program efficiency.
Centralized data for optimized member outcomes.
Learn More →improvement
Proactive care delivery with data-driven analytics empowers you to identify and address high-risk members, leading to improved STAR ratings and better patient outcomes.
Proactive care for better outcomes.
Learn More →adjustment
Operate proactively with data-driven analytics to identify and address high-risk members, resulting in better RAF accuracy and improved revenue transparency.
Maximize accuracy, minimize waste.
Learn More →Payer and health plan FAQs
How does Reveleer’s healthcare payer software deliver better results compared to siloed solutions?
Reveleer’s healthcare payer solutions unite risk, quality, and member management on a single system, providing payers with actionable insights, streamlined workflows, and measurable ROI improvements. By breaking down silos and centralizing data, health plans increase operational efficiency, lower costs, and achieve more reliable regulatory compliance. This approach is what sets Reveleer apart in the healthcare payer systems market.
What are the key advantages of consolidating all payer processes into the Reveleer Platform?
Healthcare payers using Reveleer gain faster gap closure, more accurate risk capture, seamless compliance reporting, and a unified member experience.The automation in Reveleer’s healthcare payer software minimizes manual effortand eliminates errors, while advanced analytics help optimize population health and Stars performance. These outcomes would be difficult to achieve with disconnected healthcare payer systems.
How does Reveleer’s healthcare payer system simplify compliance and adapt to regulatory changes?
The Reveleer Platform is built for continuous regulatory updates, automatically aligning with changes in HEDIS, CMS, and other programs.Transparent workflow audit trails and real-time compliance dashboards give payers confidence in their reporting, helping them maintain audit readiness effortlessly with modern healthcare payer software.
What data integration capabilities make Reveleer different from other healthcare payer solutions?
Reveleer connects to most EHRs and upstream data feeds, aggregating structured and unstructured data into the member record. Proprietary AI and automation transform healthcare payer data into insights that directly support risk adjustment, quality, and care management, giving payers a strategic data advantage within their healthcare payer systems.
Are Reveleer’s technology solutions CMS and HIPAA-compliant?
Yes, the entire Reveleer platform is compliant with CMS, HIPAA, and other regulatory bodies. We designed our platform workflows to align with CMS requirements, and our team keeps a close eye on the ever-evolving regulatory landscape to ensure processes from data acquisition to CMS submissions meet the highest regulatory standards.
How does Reveleer’s unified healthcare payer software drive measurable ROI at the enterprise level?
With Reveleer, health plans can reduce operational costs, accelerate revenue capture, and drive higher quality scores through real-time, actionable data and comprehensive automation. This enterprise-focused healthcare payer solution provides payers with precise reporting and ongoing financial optimization, supporting sustainable growth and value-based care leadership.
Related Resources
Learn how AI-powered healthcare technologies can make all the difference in increasing speed and accuracy.
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