Quality Improvement
Elevate performance with AI-driven quality improvement in healthcare
Reveleer’s Quality Improvement solution suite allows quality teams to proactively address care gaps and drive significant improvements in HEDIS® performance and Star Ratings, all while saving time and enhancing productivity.
Retrieve every relevant medical record possible, abstract them correctly, and reliably deliver the results. With Reveleer’s HEDIS solution, maximize performance on both hybrid and administrative measures.
Get more time back in the year to focus on Prospective Quality. Reduce your reliance on HEDIS season to identify at-risk members with AI-powered retrieval and abstraction.
The AI-driven Reveleer platform transforms how health plans retrieve and abstract medical records, saving time and simplifying HEDIS compliance with hybrid and administrative measures. By accelerating data retrieval and abstraction, quality teams have more time to focus on reviewing charts and improving member care.
A leading healthcare services firm wanted to accelerate medical record collection during HEDIS season. By tapping into Reveleer’s platform, they were able to automate and streamline provider outreach workflows.
Leveraging automation to identify chases met specific criteria and triggered outreach requests, eliminating manual assembly and batch uploads.
Automated follow-up statements minimized the reliance on phone calls, saving staff time, reducing errors, and improving retrieval rates.
By automating previously time-consuming tasks such as address validation and phone calls, the firm quickly lifted overall retrieval rates while also reducing manual errors.
The Reveleer platform seamless integrates with any certified HEDIS engine, avoiding the needs for complicated chase list uploads, and complaint reporting. No matter what system you use to report on quality measures Reveleer takes the stress off cumbersome data management and keeps you focused on delivering care.
Introducing the next evolution of medical record retrieval, designed to help you collect medical records up to 80% faster. After retrieval, seamlessly navigate patient charts to identify coding discrepancies and potential care gaps, increasing abstractor efficiency by 75%.
Introducing the abstractor’s AI assistant, EVE. Our Evidence Validation Engine directly supports more than 40 quality measures including immunizations status, blood pressure control, cancer screenings, and other administrative, digital, and hybrid measures. Get the data you need to support quality improvement with insights linked directly to clinical source documentation for easy reference.
This comprehensive guide reveals the most common obstacles holding health plans back and provides actionable solutions to help you drive performance, reduce provider abrasion, and achieve operational success.
The Reveleer platform extracts structured and unstructured clinical data from disparate clinical systems to deliver insights across value-based care programs.
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EVE guides abstractors to clinical insights linked seamlessly to source documentation to optimize your quality improvement programs.
Patient Index is a consolidated collection of linked patient data mined from multiple sources and systems for a unified view of patient care across risk adjustment and quality improvement.
Everything healthcare organizations are doing to close care gaps and improve patient health outcomes relates to quality improvement. For health plan quality teams, this means meeting standards like HEDIS, reporting deadlines and improving STAR ratings, important levers of financial success that also impact reputation and influence member enrollment. In addition to HEDIS compliance requirements, quality improvement teams identify and prioritize care gaps through evidenced-based interventions to optimize condition management and improve patient outcomes year-round.
Every year, quality teams work tirelessly from January to June, focusing on HEDIS reporting. Challenges like incomplete chart coverage, high retrieval costs, and the shift to digital measures can make this process feel overwhelming, leaving little time the rest of the year to close gaps in care. Healthcare workforce shortages and tight operating margins make it challenging to staff up enough to proactively focus on patient care. Healthcare organizations need to innovate with technology to manage data and improve health outcomes – using fewer resources.
Intelligent data acquisition can accelerate medical record retrieval and process medical charts more quickly for abstractors. This gives abstraction teams more time to review records, ensure HEDIS compliance, and identify gaps in care. Intelligent data acquisition gives health plans access to greater quantities of relevant data allowing quality teams to easily identify areas for improvement, including drilling into specific HEDIS measures. In this way they can work year-round to improve HEDIS scores and close critical patient care gaps.
Artificial intelligence is a powerful tool that can assist medical coders and abstractors in accelerating quality improvement processes. Reveleer’s AI-powered technology can process both structured and unstructured clinical data – from disparate sources, and in disparate formats – to generate highly accurate insights. Not only does this technology increase organizational efficiency, it can identify care gaps with incredible accuracy to drive better outcomes for patients.
Yes, AI enhances workflow automation by automating manual tasks and reducing the errors that occur with manual processes. AI can help route documents when and where they are needed and can highlight insights to improve abstraction productivity and accuracy. AI also helps organizations better allocate resources through increased efficiency and better decision-making.
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 meets the highest regulatory standards.
Gain insights into how AI-powered solutions can improve operational efficiency and quality of care.
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Explore how intelligent automation enhances HEDIS reporting, streamlines workflows, and improves data accuracy for better healthcare outcomes.
Read how AI overcomes the five most common hurdles to Quality Improvement Excellence in healthcare.
See how automation transformed provider outreach for a leading healthcare services firm, increasing efficiency, and boosting retrieval rates and meeting stringent HEDIS deadlines.
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