Reveleer Introduces Clinical Data Repository to Establish a Unified, AI-Enriched Member-Level Clinical Record for Health Plans
AI / Machine Learning | 4 min read
Reveleer, a leading provider of AI-enabled solutions empowering data-driven health plan performance, has announced the launch of Clinical Data Repository — a centralised, AI-enabled clinical data management solution designed to help health plans reliably store and reuse medical records across risk adjustment, quality reporting, audit response, and care management programmes. The solution directly addresses one of the most operationally costly problems in health plan administration: the same clinical record being retrieved multiple times, by different teams, for different programmes — a practice Reveleer estimates occurs an average of 2.5 times per record per year across the industry. Reveleer manages, reads, and processes more than 1.2 billion pages of clinical data annually on behalf of more than 55 health plans.
"Health plans are being asked to support increasingly complex reporting and audit requirements, often without a unified clinical data foundation. Clinical Data Repository provides a reusable clinical record at the member level, allowing organisations to reduce duplicate retrieval, coordinate across teams, and submit with a more complete clinical record. As health plans face heightened scrutiny across every major programme, having one trusted member-level record is no longer a convenience — it is a strategic imperative."
— Jay Ackerman, CEO, Reveleer
The Problem: Duplicate Retrieval Across Fragmented Programmes
Health plans today operate risk adjustment, quality improvement, RADV and IVA audit, and care management as operationally separate programmes — each pulling the same member records independently. The same clinical chart may be retrieved once for a risk adjustment coding review, again for a quality gap closure, and again to respond to an audit request. This fragmented, episodic retrieval model creates three compounding problems: significant retrieval cost from repeated outreach to providers; provider abrasion from repeated requests for the same records; and data inconsistency when different teams work from different versions of the same record. By retrieving medical records once and reusing them across programmes, Reveleer estimates health plans can eliminate hundreds of thousands of hours of redundant retrieval work annually — often reducing retrieval effort by 30–60% while shortening programme timelines and improving provider experience.
How Clinical Data Repository Works
Clinical Data Repository establishes a reusable member-level clinical record as a foundational data layer — a single, centralised repository where medical charts are uploaded once, enriched with AI, and made available across every enterprise programme without re-retrieval. The repository integrates with EHRs, Health Information Exchanges (HIEs), retrieval vendors, and internal data warehouses via SFTP or API, ingesting structured and unstructured data from EHRs, HIEs, labs, claims, and specialty networks to build a longitudinal member record. Every chart is indexed and searchable by member, provider, group, and dates of service. Once stored, records can be used across risk, quality, and audit projects simultaneously — with newly retrieved members and charts syncing automatically. The repository is enriched by EVE™ Hybrid AI, Reveleer's evidence extraction engine built on Google Cloud (Gemini and Vertex AI), which extracts clinical evidence from charts and applies clinician-authored deterministic formulas to surface diagnosis and care gap opportunities — combining generative AI capability with audit-ready explainability. The solution is built on a HITRUST-certified foundation, with governance controls including audit traceability, role-based access, and HIPAA compliance support.
Key Takeaways
- • Reveleer has launched Clinical Data Repository — a centralised, AI-enabled solution for health plans to store medical records once and reuse them across risk adjustment, quality reporting, RADV/IVA audit response, and care management — eliminating the industry-estimated average of 2.5 retrievals per record per year across fragmented programmes.
- • The core problem it solves: duplicate retrieval across operationally siloed risk, quality, and audit programmes — creating retrieval cost, provider abrasion, and data inconsistency risks. Reveleer estimates a 30–60% reduction in retrieval effort and elimination of hundreds of thousands of hours of redundant work annually when records are pulled once and reused across programmes.
- • The repository integrates with EHRs, HIEs, retrieval vendors, and data warehouses via SFTP/API; ingests structured and unstructured data (EHR, HIE, labs, claims, specialty networks); indexes every chart by member, provider, group, and dates of service; and enables concurrent reuse across risk, quality, and audit projects without re-retrieval.
- • Clinical Data Repository is enriched by EVE™ Hybrid AI (Google Cloud, Gemini, Vertex AI) — Reveleer's evidence extraction engine that combines generative AI chart reading with 3,300+ clinician-authored deterministic clinical rules — providing explainable, audit-ready AI outputs linked to source documentation across every diagnosis and care gap insight.
- • Built on a HITRUST-certified foundation with HIPAA compliance controls, audit traceability, and role-based access — enabling risk adjustment, quality, and audit functions to move from episodic retrieval cycles toward continuous documentation reuse, accelerating audit response timelines and strengthening data consistency across regulatory submissions.