Reveleer Launches NLP-Driven HEDIS® Data Overread Built for Speed and Accuracy of Quality Improvement Programs

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Today, Reveleer will roll out new functionality that introduces an entirely new HEDIS® workflow powered by natural language processing

Reveleer, a healthcare technology company that enables health plans to take total control of their government quality and risk adjustment programs, today announced the extension of its platform’s capabilities to include powerful Natural Language Processing (NLP) that will resolve mission-critical challenges for the overread of medical charts to comply with HEDIS® programs.

Reveleer's NLP-Driven HEDIS® Overread provides customers the ability to increase the volume and accuracy of overread to ensure all compliant HEDIS® measures have been captured from medical records. Currently, health plans perform this important task in a closed system, relying on costly manual review. This time-consuming process does not provide the agility and assurance HEDIS® audits demand.

Reveleer’s software provides full transparency into the overread process. With the addition of NLP, this platform offers a dynamic solution for health plans to completely overread all hybrid measures and select administrative measures with 97% confidence. This automation allows customers to effortlessly perform 100% overread independently within the platform with internal resources or utilizing Reveleer’s experienced abstraction team.

Using Machine Learning (ML), Reveleer’s NLP engine will review the medical record and validate numerator events documented by the primary abstractor. The engine returns results, indicating whether our NLP algorithm has found a match, partial match, or no match to those documented events. Each match and partial match will also contain annotations for the specific dates of service and related results. All chases reviewed by Reveleer’s NLP can be routed for further human evaluation if desired.

“Reveleer believes innovative NLP technology can be used to solve fundamental industry challenges. Although the technology has been in the market for some time, our goal is to elevate its application to solve key quality improvement functions and to provide health plans with the maximum level of choice, transparency and control over their government programs,” said Jay Ackerman, Reveleer CEO. “With our NLP-Driven HEDIS® Overread solution, we’re proud to further empower our health plan clients using intuitive ML to help them achieve outstanding results often during critical time compressed cycles.”

“Rarely have I met a team as talented as Reveleer’s,” said Ren Roome, Principal, Boston Millennia Partners. “Healthcare is a large market currently being revolutionized by the perfect storm of users pushing for more innovation, and health plans seeking advanced technology so they can serve communities better and manage the transition to value based care. This creates an opportunity to rethink how things have been done for decades, placing Reveleer in an advantageous position with their new NLP solution applied to HEDIS® overread.”

In addition to this game changing innovation, NLP-Driven HEDIS® Overread, Reveleer will be debuting additional NLP functionality to automate Risk Adjustment review in Q4 2020.

About Reveleer
Reveleer is a healthcare software and services company that uses Machine Learning and Intelligent Automation technology 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.

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