Reveleer Platform
Thursday, March 21, 2024
Welcome to the March 2024 release notes from Reveleer! As the world bids farewell to the winter chill and welcomes the budding signs of spring, we invite you to join us in celebrating the vibrancy of this season of renewal. Just as March brings forth a sense of rejuvenation and excitement, our latest release is packed with innovative features and enhancements designed to invigorate your platform experience. So, dust off those winter blues and get ready to embrace the freshness of spring with our March release.
Member Management
Update! Enhanced Revenue Reconciliation Calculations For EGWP Members
To align with the CMS regulatory change to the Employer Group Waiver Plans (EGWPs) payment structure, Revenue Reconciliation calculations have been updated to reflect MA rate book base rates. Ensure accurate calculations in accordance with the latest CMS compliance requirements when monitoring and resolving payment discrepancies for EGWP members on the Reveleer platform.
Data Load
New! Introducing Data Load With Annotations
Reveleer is thrilled to announce new data load capabilities designed to ensure critical information is readily accessible to coders during chart review. Users can now include notes to be displayed as chart annotations in data entry mode when uploading chases. Include coding guidelines for clarity, unique identifiers for easy tracking or any additional relevant information for coders to reference without leaving their workflow.
Retrieval
Update! SFTP Ingestion Now Supports Additional File Formats
The enhanced SFTP data load feature keeps improving with now even more support for ingestion of additional formats. Leverage a wide range of clinical data within the platform by uploading medical records in various file formats including TIFF, PNG and JPEG, in addition to PDF.
HCC Analytics
Update! RAF Auto Determination Now Supports All Lines of Business
Quickly gain insight into Risk Adjustment Factor (RAF) projections for all HCC risk adjustment programs with the latest RAF Auto Determination upgrade. The RAF Auto Determination feature now supports automatic risk score calculations for Medicaid (CDPS, ACA) plans in addition to Medicare Advantage, offering streamlined financial forecasting across all lines of business that rely on RAF score calculations for accurate reimbursement.
Update! “Member Problem List” Report Enhancement
The Risk Adjustment Payment System (RAPS) is sunsetting and the “Member Problem List” report has been updated accordingly. The enhanced report now draws on the rich data captured in Encounter Data System (EDS) submissions to determine risk-adjustment eligible diagnosis. Leverage the comprehensive and detailed encounter data within EDS to conduct robust HCC analytics.
Clinical
New! Risk 2.1 Now Supports Multiple Models
CMS has begun to phase out the V24 model, and Reveleer is here to help make the transition to V28 as smooth as possible. Risk 2.1 data entry now supports the use of multiple models, in accordance with CMS requirements for HCC capture. Users can now create projects for HCC V24, V28 and RxHCC models, ensuring accurate code assignments according to the requisite level of specificity and severity across all models.
Update! Risk 2.1 Enhanced Code Capture with Net New HCC and RxHCC cards
Unlock complete code capture at maximum efficiency with the latest DX review mode upgrade. You can now add net-new HCC and RxHCC cards, ensuring comprehensive coverage of all relevant HCC categories while reviewing charts. This upgrade builds upon the recent code capture enhancement that enables adding diagnoses to existing DX cards, announced in December.
New! DX Review Mode Now Supports Admin Data Load
Experience enhanced flexibility and comprehensive code capture with the latest update to Reveleer's DX review mode. You can now load administrative claims in addition to clinical data for First Pass NLP review and coder validation in DX review mode. Elevate coding accuracy with a broader set of source data and streamline data workflows by eliminating the need to switch between systems during review.
Update! Quality Prospective MY2024 Measure Update
Introducing a new addition to the Reveleer platform measures offered for quality prospective MY2024: the Glycemic Status Assessment for Patients with Diabetes (GSD). The GSD measure assesses the percentage of members aged 18–75 years of age whose most recent glycemic status indicates compliance during the measurement year.
New! Automatic NLP Activation for Quality Projects
Introducing automatic NLP activation for measures in quality projects. This enhancement simplifies your workflow by automatically turning on First Pass NLP for all measures when chases are loaded, eliminating the need to manually activate NLP in project settings. Rest easy knowing that NLP has been applied consistently across all measures upon data load without the extra step.
Update! Quality: EVE Page Numbers Now Editable
The latest enhancement to the quality review workflow offers increased accuracy and precision when validating clinical evidence for quality projects. You can now edit EVE-identified page numbers to pinpoint relevant evidence for quick and easy reference.
Analytics
Update! “Coding Duration” Report Upgrade
The Risk “Coding Duration” report has been upgraded to offer flexibility and increased visibility into coder productivity. The report now boasts a high-level coding overview for at-a-glance insight into coding durations by coder. Clinical managers can also now choose a specific timeframe when viewing coding duration stats to better identify trends and areas for improvement over time.
Update! “Validation Reason Code” Report Now Includes Filter-By-Date Functionality
Incremental reporting has never been easier thanks to the latest “Validation Reason Code” report enhancement! Choose a time frame when viewing diagnoses by validation reason with the new filter-by-date functionality. This enhancement empowers program and clinical managers to monitor status throughout the chase lifecycle for more timely, proactive decision making and performance management.
Update! “Chase Counts and Pend Counts” Report Enhancements
The “Chase Counts and Pend Counts” report has become a customer favorite for at-a-glance insights into chase status so we’ve doubled down with the latest enhancements. Users can now view chase counts and pend counts by vendor and vendor invoice type for focused assessment and more targeted outreach.
Update! “Retrieval Summary” Dashboard Boosts Drill Down Functionality
The “Retrieval Summary” dashboard has been enhanced with drill down capabilities into AIDs. Users can now view the Top 50 AIDs (50 addresses with the highest open chase counts) by customer name and vendor invoice type for easier tracking and follow up. A new vendor invoice type filter has also been added for sharper focus when monitoring retrieval status. Target allocation of retrieval resources for the highest volume sites armed with vendor and customer details.
Miscellaneous
Various performance and stability enhancements