Reveleer Launches Machine Learning Solution for Payers to Improve Risk Adjustment Performance

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The new solution leverages Intelligent Automation and Machine Learning technology to accelerate the capture of risk adjustable data.

Reveleer, a healthcare technology platform that enables health plans to take total control of their Quality Improvement and Risk Adjustment programs, today announced the addition of powerful Natural Language Processing (NLP) capabilities to enable dramatic efficiency improvements in the coding of medical records for Risk Adjustment programs.

Reveleer's NLP Total Capture provides health plans across all lines of business the ability to increase the volume and accuracy of their Risk Adjustment coding efforts by enabling an automated NLP workflow to perform first pass coding of medical records. Currently, coders must manually scan the medical record and perform coding using tools that are not part of a complete workflow. This process is labor and time-intensive, particularly as medical records can be hundreds or even thousands of pages long. Manual-only coding is expensive and thus often limits the size and scope of a health plan’s Risk Adjustment efforts.

Reveleer’s NLP Total Capture has access to millions of patient records, hundreds of millions of medical document pages, and billions of evidence terms in its NLP library. A massive volume of medical intelligence is used to uniquely optimize the machine learning models resulting in highly accurate insights with a 95% success rate.    

“The introduction of our NLP Total Capture solution delivers a market leading primary coding solution in a true SaaS model, enabling health plans to fully control these critical initiatives”, remarked Jay Ackerman, CEO of Reveleer.

With Reveleer’s NLP Total Capture medical records are processed within minutes, regardless of page count once uploaded to the Reveleer platform. Medical records are uploaded, documents are attached to a chase, chase and PDF documents routed through the NLP, and results are returned for coder validation. The results from the NLP include member validation, provider confirmation, validation of claims dates of service and associated ICD codes, identification of net new dates of service and associated ICD codes, highlighting of keywords that support a diagnosis, and the ability for staff to review ICD codes found within false positive sections of the medical record and should not be captured (e.g. medical history, patient reported, etc.)

The Reveleer platform provides full transparency into the Risk Adjustment coding process, from record retrieval through to completion of coding. Health plans can also see the full status of their Risk projects at all project stages and can review how many diagnosis codes (and when applicable the associated HCCs) are being captured in near real-time.

With today’s launch, Reveleer adds a powerful complement to its existing Machine Learning-enabled Quality solution, NLP-Driven Overread for Quality Review, which enables health plans to fully automate the overreading of medical records for their HEDIS® programs and establishes Reveleer as a leader in the capture and review of critical clinical data.

About Reveleer
Reveleer is a healthcare technology company that uses Machine Learning and Intelligent Automation to empower payers in all lines of business to take control over their Quality Improvement and Risk Adjustment programs. The Reveleer platform enables payers to independently execute and manage every aspect of provider outreach, retrieval, coding, abstraction, and reporting – all under one platform. Leveraging proprietary technology, robust data sets, and subject matter expertise, Reveleer also assists payers with full record retrieval and review services to support financial performance and improved member outcomes. https://www.reveleer.com

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