Reveleer Launches Industry's First All-in-One RADV Audit SaaS Solution for Medicare Advantage Compliance

The AI-enabled solution addresses expanded CMS RADV requirements with automated workflows, audit-ready reporting, and scalable operations developed based on insights from leading health plans.

LOS ANGELES, Oct. 15, 2025 /PRNewswire/ -- Reveleer today announced the launch of its comprehensive RADV Audit SaaS Solution. Developed for Medicare Advantage plans managing complex CMS RADV audits, the new technology is part of their risk adjustment suite and serves as the market's first fully unified solution from retrieval to submission. The all-in-one solution brings together automated enrollee data management, multi-year retrieval and risk coding, automated provider attestation pursuits, pre-built submission packages, and real-time project reporting into a single, defensible workflow for audit readiness across every contract and year. Co-developed with some of the nation's leading Medicare Advantage organizations, the solution reflects real-world operational insights and health plan feedback at every stage.

Medicare Advantage organizations are confronting expanded member samples, years-long historical lookbacks, compressed submission timelines, and greater financial exposure due to error extrapolation. These rigorous demands call for technology that delivers reliability, defensibility, and operational scalability — not manual effort or fragmented tooling. Reveleer's unified solution is designed to reduce operational burden, increase coding accuracy, and improve audit transparency from intake through submission, so teams can move faster and while supporting compliance obligations.

"RADV audits are no longer a back-office burden; they're a strategic risk and compliance priority. Health plans need more than tools. They need a solution built with their real-world complexity in mind," said Paul Burke, Chief Product Officer at Reveleer. "That's why we developed this solution based on the needs and feedback of health plans, giving payers full control and defensible coding accuracy for audit readiness across every year and contract. This is automation informed by payer experience and shaped by payer priorities."

Technology That Drives Confidence
Reveleer's RADV Audit SaaS Solution hosts core capabilities to ensure consistent, scalable execution, even under tight CMS deadlines, including:

• Automated CMS enrollee data ingestion, crosswalks, and reconciliation for member cohorts and historical records — even when sourced from prior vendors or archives.
• End-to-end workflows for retrieval, coding, quality assurance, and submission packaging across multiple payment years and models, enabling consistent execution at scale with tight deadlines.
• AI-enabled coding and evidence validation with EVE^™, Reveleer's AI engine, which supports dynamic validation, confidence scoring, and multi-level QA.
• Built-in adaptability for evolving HCC models and regulatory frameworks to maintain audit readiness.

The platform also includes a provider attestation workflow to streamline documentation collection and reduce administrative friction, with automated outreach, document management, and status reporting.

Health plan leaders and administrators benefit from interactive, real-time dashboards with drilldowns insights into progress and gaps, QA tracking and collaboration to keep projects on track and on time.

Built with Health Plans, for Health Plans
Reveleer gained insights from leading Medicare Advantage organizations to shape its RADV Audit SaaS solution around real-world challenges. From multi-year contract complexity to provider engagement and audit traceability, the platform reflects deep collaboration with payers on the front lines of compliance.

Unlike services-heavy approaches, Reveleer's new solution unifies the entire RADV process under a technology-first model. By eliminating silos and manual dependencies, health plans can:

• Promote audit readiness with consistent, auditable workflows
• Reduce risk of extrapolated recoupments
• Meet deadlines with confidence
• Maintain transparency across audit years and contracts

As CMS guidance and audit protocols continue to evolve, Reveleer's RADV Audit SaaS Solution is able to adapt, giving payers the agility and insight needed to maintain agility and oversight for operational success. Organizations can deploy the solution as self-service, managed, or in a hybrid model to match internal capacity and timelines while maintaining control and audit traceability.

The RADV Audit solution is available now. To learn more, visit Reveleer's website.

About Reveleer
As the industry's pioneering value-based care (VBC) technology platform, Reveleer helps solve the most pressing real-world challenges faced by providers and health-plan organizations today. By unifying retrieval, clinical intelligence, risk adjustment, quality improvement, and member management solutions into one intelligent, AI-powered system, Reveleer streamlines fragmented workflows to supercharge productivity, enhance care quality, and optimize performance on high-priority value-based initiatives. Learn more about Reveleer's value-based care platform.

SOURCE Reveleer