Reimagining Retrospective Risk: smarter, faster, more reliable

We’re thrilled to share the launch of Reveleer’s next generation Risk Adjustment technology, a powerful approach to retrospective risk that’s even faster and more accurate than before.

Far too often, payers grapple with improving their risk adjustment programs with processes that don’t scale. The time and resources it can take to complete record retrieval and clinical coding processes often limits payers’ ability to grow their member base—and threatens their ability to stay compliant. Unfortunately, current technologies and manual processes are fragmented, time-consuming, and prone to errors.

Nevertheless, a strong retrospective risk program has never been more important. Navigating an increasingly complex regulatory environment and heightened scrutiny on payment integrity requires sophisticated technology that’s purpose-built for compliance. Furthermore, as value-based care continues to become the standard by which health plans are measured, ensuring risk adjustment is efficient and accurate is foundational to meeting cost and quality goals.

Reveleer’s next-generation Risk Adjustment technology helps payers meet these challenges head on. By incorporating advanced healthcare AI technology, an intuitive user interface, and streamlined automated workflows, our technology helps payers effortlessly reach their risk adjustment goals.

What to expect from next-generation risk adjustment

Reveleer’s value-based care platform has streamlined retrospective risk adjustment for countless payers already—from chart retrieval to submissions. The foundation of our risk adjustment technology is more powerful than ever before, encompassing;

• Advanced medical record retrieval. Reveleer’s risk adjustment suite extracts clinical evidence at speeds up to 96k pages per hour and transforms structured and unstructured data into suspected diagnoses.    

• Highly accurate diagnosis detection. Our AI-powered assistant, EVE™, helps payers achieve faster, more accurate clinical review by identifying potential missed diagnoses with 99% accuracy.*

• Smart Recapture. Using chase prioritization and optimization suppression, at-a-glance clinical review, and one-click validation, you can minimize coding errors and improve RAF capture and compliance.

• Submissions, purpose-built for compliance. Our technology facilitates timely and accurate submissions with 98% CMS acceptance rates.

• Insight-rich analytics. Reveleer’s comprehensive reporting and analytics capabilities helps teams gain a full view of end-to-end program activity over time.

With our newest evolution of Risk Adjustment, we’re introducing even more powerful capabilities to further your efficiency and quality goals:

• ‍Dynamic validation. Using our proprietary AI, our retrospective risk coding technology now adapts in real time to coder HCC validation, reducing redundant tasks and errors and enhancing coder efficiency.

• Customizable diagnosis table. We've streamlined diagnosis review with more comprehensive health profiles and features like multi-column sorting, bulk validation actions, and advanced filtering options in our updated diagnosis table.

• ‍Flexible chart viewer. Now, risk teams can access medical records in multiple viewing modes (grid, detail, or filmstrip) for easier navigation and analysis.‍

• ‍Better user experience for better collaboration. To make risk adjustment teams even more productive, our Risk Adjustment suite now includes inline annotations, customizable markups, and history tracking. Features like dual-screen support, bulk actions, and dark mode further ease the cognitive burden for users
  

Modern risk adjustment for success in value-based care

Reveleer's Risk Adjustment suite is part of our comprehensive value-based care enablement platform which powers Quality Improvement, Clinical Intelligence, and Member Management through AI-powered tools, lightening-speed processing, and an impeccable user experience. In 2024, we processed 1.1 billion pages of medical charts and delivered 2.5 million diagnoses. With this powerful engine working for them, payers can modernize their risk adjustment programs, making them faster and more accurate than before.

• Reveleer's platform delivers clinical insights with up to 99% accuracy, minimizing coding errors and improving RAF capture.

• Using intelligent automation, we can reduce coding duration by 42.5%.

• Our solution also accelerates retrieval success, saving on average 1,100 hours.

• Finally, our comprehensive Risk Adjustment technology improves overall RAF capture by 33% for unparalleled clinical and financial impact.

Reveleer is reimagining retrospective risk to deliver remarkable accuracy, productivity, and financial performance for payers of all sizes. Interested in our modern approach to risk adjustment? Schedule a demo with us to experience the results.

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^{* Results vary depending on configuration settings, team mix, and chart density. Reveleer expert guidance on program set up recommended.}