As value-based care scales, health plans and risk-bearing providers need a smarter approach to risk adjustment. Inefficiencies, administrative burdens, and provider abrasion can impact program success. Reveleer’s Retrospective Risk Solution empowers health plans, including Medicare and Medicare Advantage to excel with transparent, generative AI and workflow technology for unparalleled accuracy, compliance, and financial performance.
Our solution securely breaks down data silos, transforming both structured and unstructured data into intelligent HCC coding predictions and analysis to optimize programs, ensure RAF accuracy and maximize value-based care success. Reveleer's Risk Adjustment Analytics monitors beneficiaries' health status and optimizes financial performance for value-based care programs.
Utilize claims encounter data to accurately predict future revenue adjustments.
Monitor the accuracy of risk capture and identify potential gaps in coding.
Pinpoint opportunities to improve RAF accuracy and close gaps in care
Gain invaluable insights to project future risk scores and revenue by sweep cohort
With at-a-glance diagnosis review, page reference, multiple view options, advanced filtering, and bulk actions users spend less time searching for evidence and more time reviewing it.
Users can collaborate faster without sacrificing accuracy. Managers can compare coder vs. over reader edits in real time directly in the application for better collaboration without email back and forth.
Safeguard against potential financial and reputational risks associated with overpayments.
Reveleer’s Retrospective Risk software, powered by our Evidence Validation Engine, EVE™ empowers health plans and risk-bearing providers to achieve complete and accurate diagnosis capture with significantly less effort.
EVE™ builds coder trust through its reliance on M.E.A.T. standards for clinical discovery with full chart reference-ability for more transparent HCC coding predictions and improved RAF accuracy.
Reveleer has been a certified auditor since the program's pilot year in 2016. Our experienced team and transparent platform ensure a smooth and successful audit experience:
Leverage Reveleer's technology for accurate and efficient review of various aspects of the audit, including:
Close gaps in care and improve patient outcomes
Pharmacy RXC claim validation
Medical record retrieval
Health status validations
HCC-mappable diagnosis code review
Provider signature attestations
We establish a clear cadence, project plan, and timeline to guide you through the entire audit process.
Our proprietary software platform provides complete visibility and communication throughout the audit.
Rely on Reveleer's expertise to ensure a successful final audit submission.
Reveleer's end-to-end solutions empower value-based care organizations to submit risk audits for Medicare Advantage and ACA plans. Our platform simplifies the process with:
Ensure data consistency across all submitted files for accurate processing.
Eliminate manual tasks and streamline submission workflows.
Quickly identify potential errors for swift resolution.
