Reveleer, a healthcare technology company using artificial intelligence (AI) to empower data-driven healthcare for payers and providers in all lines of business, announced significant enhancements to its AI-enabled prospective risk adjustment solution. Through EHR-agnostic connections, the Reveleer platform packages pertinent patient information as a pre-encounter summary and shares it directly with the provider to proactively close care gaps, leading to better revenue performance, more accurate reimbursements, and better health outcomes. The new GetNext capability enables highly efficient, proactive risk adjustment, optimizing workflows for risk and quality teams by consistently prioritizing the next-most-valuable data for coding and abstraction per customizable rule sets.
The key to Reveleer’s prospective risk adjustment capabilities is its unique data acquisition model that eliminates data silos by leveraging multiple structured and unstructured sources across the care continuum: multiple HIEs, all hospital and specialist EHRs, medications, and labs to create a comprehensive, longitudinal clinical record for members/patients, regardless of the source of the care encounter. Using proprietary AI technology, including Natural Language Processing (NLP) and Machine Learning (ML), the Reveleer solution automates, accelerates, and improves clinical data coding and abstraction while reducing errors, inefficiencies, and program costs. With GetNext, teams work efficiently, focusing on the highest-value cases based on essential parameters indicating where care gaps, coding, or documentation issues may be present.
Leveraging this comprehensive member/patient record, relevant data is summarized and delivered to the provider, giving insight about care gaps – or potential care gaps – before the patient encounter. Bi-directional integration with the EHR delivers information to the provider and then returns data from the provider to the longitudinal record for concurrent and retrospective analysis. Making valuable information available at the point of care enables prospective risk adjustment, eliminates reimbursement delays, increases the accuracy of Risk Adjustment Factor (RAF) scores, and improves revenue performance.
SOURCE: PR Newswire