Case Study: a large not-for-profit health company achieves 6X ROI and $18.5M revenue capture with Reveleer’s Point of Care Suspecting Solution

Enhancing revenue capture and outcomes with advanced patient targeting

A large not-for-profit health system faced challenges in its risk adjustment and quality improvement programs for its 180,000 Medicare Advantage and MSSP members. Gaps in care documentation limited its ability to proactively identify patient conditions, which negatively impacted its financial performance. The company turned to Reveleer for a solution.

Reveleer implemented its point-of-care suspecting solution, which leveraged over 1,500 clinical rules and integrated with the health system's Epic EHR. This allowed for pre-visit patient reviews and simplified care gap identification. The implementation by Reveleer resulted in a 34% improvement in the suspect HCC provider address rate, a 6X return on investment, and $18.5 million in enhanced revenue capture.