Case Study: a large regional health plan codes 1.2M charts in 4 months with Reveleer AI-powered clinical coding

How a large regional health plan coded a year’s worth of medical records in four months with Reveleer

A large regional health organization faced challenges in scaling its risk adjustment coding operation for its growing Medicare Advantage business. The organization, managing over one million medical charts annually, was concerned about its ability to handle the volume cost-effectively, which risked inaccurate RAF scores and lost reimbursements. To address this, they turned to Reveleer for a solution involving their AI-powered Evidence Validation Engine.

Reveleer's solution used its proprietary Evidence Validation Engine, EVE, to analyze clinical data and pinpoint relevant evidence for human coders to review. This allowed the organization to code 1.2 million charts in just four months, achieving a threefold increase in coding speed. The implementation resulted in a 40% increase in the value per chart and a 30% improvement in workflow efficiency for the large regional health organization.