A new evolution in patient insights with prospective risk adjustment
Complete and accurate gap closure at the point of care
Achieve superior financial and clinical outcomes at scale. Reveleer’s Clinical Intelligence Solution taps into a nationwide network of clinical data to build a complete picture of patient health, delivering the insights necessary for success in value-based care.
Comprehensive diagnosis capture
Capture all relevant diagnoses, including net-new suspects as well as previously documented conditions, from rich and diverse sources of clinical data across the spectrum of care.
Advanced risk stratification
Prioritize high-risk patients and direct prevention and outreach efforts to those most in need of intervention and disease management.
Provider engagement without disruption
Accelerate provider adoption of prospective gap closure programs through frictionless insertion into existing EHR workflows.
Insights for prospective risk adjustment, delivered when and where they’re needed
Reveleer’s AI-powered Clinical Intelligence Solution delivers clinical insights where they matter most—at the point of care. By surfacing gaps in diagnoses in real time, providers can access actionable insights when they need them most and confirm and document diagnoses with just a few clicks.
Improve revenue capture and patient outcomes with clinical intelligence
A not-for-profit healthcare system wanted to close gaps in its care documentation to improve outcomes and financial performance. It partnered with Reveleer to proactively identify and address patient conditions and deliver them directly to providers at the point of care.
34% improvement in HCC provider address rate
Leveraging 1,500+ automated clinical rules, the health system identified diagnosis gaps and delivered these insights directly to providers at the point of care.
$18.5+ million enhanced revenue capture
Improvements in HCC coding and risk adjustment helped the health system secure millions in enhanced revenue capture.
6X return on investment
Delivering clinical insights directly into the system’s existing Epic EHR workflow made it simple to close documentation gaps and improve financial performance.
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Key features that power smarter prospective risk adjustment
Unified multi-source data aggregation
Discover Reveleer's powerful approach to prospective risk adjustment. From unified data aggregation to AI-powered gap detection and EHR integration, Reveleer’s Clinical Intelligence Solution streamlines workflows, enhances documentation accuracy, and delivers actionable insights at the point of care.
AI-powered gap detection
Access patient records from specialists, hospitals, and community providers through established bi-directional integration with EHRs and HIE systems nationwide with Reveleer’s multi-channel electronic retrieval technology.
Insights at the point of care
Prepare for patient encounters with pre-visit clinical documentation improvement so clinicians can focus their attention on patient care. Reveleer simplifies pre-visit, point-of-care, and post-visit workflows with minimal disruption to care delivery.
Webinar
Learn how to use clinical intelligence to power your quality improvement goals
Join Equality Health’s Chief Clinical Officer and Reveleer’s Solution Architect to learn how to leverage AI-powered clinical insights for improved patient outcomes and reduced provider abrasion. Discover strategies to enhance clinical decision-making, streamline workflows, and strengthen population health management.
Smarter technology, superior results for risk adjustment
Intelligent data acquisition
The Reveleer Platform extracts more than 96K pages of structured and unstructured clinical data, consolidated from several disparate clinical systems, to deliver insights in real time across value-based care programs.
EVE™, our Evidence Validation Engine
EVE guides abstractors to member insights linked seamlessly to clinical source documentation to optimize the clinical review process.
Patient Index, a holistic view of care
Patient Index is a consolidated collection of linked patient data mined from multiple sources and systems for a unified view of patient care across member management, risk adjustment, and quality improvement.
Understanding prospective risk adjustment in healthcare
What is prospective risk adjustment and why is it important?
Prospective risk adjustment helps risk-bearing organizations gain visibility into patient risk so they can more accurately predict healthcare costs and proactively address gaps in care. Prospective risk adjustment can supplement retrospective audits by delivering an accurate picture of patient health well ahead of retrospective deadlines.
How can AI support prospective risk adjustment?
AI can support data extraction, analysis, and workflow automation to make prospective risk adjustment more accurate and more efficient. By leveraging AI to identify undiagnosed conditions and deliver insights at the point of care, healthcare organizations gain better visibility into patient health, improving condition management.
How does clinical intelligence technology help pinpoint gaps in care?
Clinical intelligence technology supports payer and provider organizations by uncovering insights into patient risk. AI-powered clinical intelligence technology can quickly integrate large volumes of clinical data, integrate the data for consistent formatting, and accurately predict HCCs. Then, the technology can deliver suspected diagnoses directly to providers at the point of care for more impactful patient encounters.
What types of data can clinical intelligence technology analyze?
Clinical intelligence technology such as Reveleer’s Clinical Intelligence Solution can integrate and analyze data from health information exchanges, networks, claims, pharmacies, labs, and even unstructured clinical notes.
Does clinical intelligence technology integrate with electronic health records (EHRs) and other systems?
Reveleer’s Clinical Intelligence Solution integrates with leading EHRs. Insights into patient risk are delivered straight to the EHR at the point of care so providers can access suspected HCCs with minimal clicks.
What level of visibility do providers have into AI decision-making processes?
Providers are easily able to access clinical documentation at the point of care that supports suspected diagnoses. By accessing key points in the patient’s healthcare history and utilization, they can better understand HCC predictions and make the most informed treatment decisions possible.
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.
What other solutions does Reveleer provide to support success in value-based care?
In addition to our powerful Clinical Intelligence Solution, Reveleer offers a single platform for value-based care that incorporates Quality Improvement, Risk Adjustment, and health plan Member Management technology suites.
Related Resources
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