Novillus Unclaimed

Improves quality and risk management while enhancing provider engagement and operational efficiency.

Streamlines chart review processes to enhance efficiency and accuracy in health plan operations.

Clean ensures perfect provider directory accuracy for health plans, enhancing compliance and customer satisfaction.

Capabilities that engage provider groups and manage the care gap lifecycle through actionable gap lists, multichannel outreach, provider incentives, gap closure tracking, and audit support to improve program performance.

Capabilities for continuously verifying and managing provider directory data, collecting provider-sourced details, mapping provider relationships, ensuring CMS compliance, and integrating clean data into directories.

Capabilities that automate first-level chart review and clinical abstraction with HIPAA-compliant AI to increase reviewer capacity, reduce unnecessary reviews, handle exclusions, and identify evidence across multiple gap types.

Capabilities that support HEDIS, Star ratings and risk-adjustment programs via supplemental data submission, audit support, exclusions handling, unified workflows across quality and risk gaps, and analytics to drive gap closure.

Care Gap Management

Care Gap Management is an application that blends technology and provider engagement to manage the quality and risk care gap lifecycle and improve program performance across lines of business, including Medicare and Star ratings, Medicaid, Commercial, ACA, and more.

• Monitor Provider Engagement
  Empowers organizations to track and analyze provider engagement metrics, facilitating informed decision-making to optimize programs.
• Visualize Patient Care Gaps
  Provides a clear and actionable view of care gaps, making it easier for providers to understand and address them effectively.
• Track Gap Closure Progress
  Facilitates easy tracking and management of gap closure efforts, enhancing overall performance outcomes.
• Simplify Audit Processes
  Streamlines the audit process, reducing stress for clinicians and ensuring compliance with regulatory requirements.
• Accurate Exclusion Management
  Ensures that unique situations are handled correctly, maintaining the integrity of the review process.
• Enhance Provider Communication
  Improves communication with providers, fostering collaboration and engagement while tracking incentive earnings.
• Collect Provider Feedback
  Gathers valuable feedback directly from providers to enhance programs and address concerns effectively.

Curate

Curate is Novillus’ AI-powered chart review solution for health plan quality and risk teams, transforming the chart review workflow by unifying first-level chart review across quality and risk gap types with HIPAA-compliant artificial intelligence.

• Identify Multiple Gap Types
  Enables comprehensive chart processing by addressing both quality and risk adjustments in one go.
• Expand Validator Capacity
  Increases throughput of chart reviews, enhancing operational efficiency in health plan operations.
• Ensure High Accuracy
  Maximizes the reliability of data abstraction, which is critical for compliance and quality outcomes.
• Automate Chart Review
  Streamlines workflow handling, reducing redundancy and improving time efficiency.
• Utilize Compliant AI Solutions
  Ensures data privacy and security while leveraging advanced technology for chart reviews.
• Accurate Exclusion Management
  Prevents inaccuracies by ensuring that patients that should be excluded from certain metrics are accurately processed.
• Minimize Review Waste
  Saves resources and time by cutting down on redundant chart review processes.

Clean

Clean is a provider directory information accuracy solution that quickly and efficiently powers provider directories with 100% accurate data.

• Guarantees Accurate Data
  Ensures that the provider directory is consistently accurate and up-to-date, meeting regulatory compliance requirements.
• Ensures Hassle-Free Compliance
  Eliminates the need for in-house management by providing a complete solution for maintaining directory accuracy.
• Streamlines Data Acquisition
  Collects essential provider information seamlessly and minimizes disruption to provider relationships.
• Simplifies System Integration
  Allows rapid implementation into existing systems, facilitating quick compliance with data accuracy mandates.
• Enhances Provider Satisfaction
  Provides a user-friendly process for providers, ensuring high engagement and positive feedback.
• Maps Complex Relationships
  Captures intricate provider relationships to ensure precise data management and reduce errors.