Make every encounter count.
Connect payer priorities to timely provider action — and return the evidence needed to support the result, before the measurement window closes, before the claim goes out, before the audit arrives.
event types
per evaluation
point of care
One Intelligence Foundation
The MediVu Intelligence Bridge is the real-time, event-driven foundation connecting payer priorities, live clinical data, and provider workflows. It evaluates evidence as events occur and routes actionable intelligence to the appropriate payer, practice, or clinician workflow.
priorities, evidence, workflows, and results
Payer Intelligence
Network priorities
Practice Intelligence
Encounter readiness
Clinician Intelligence
Point-of-care action
DESIGNED FOR HEALTH PLANS
Built for the priorities that health plans must get right
Risk adjustment and revenue integrity
Validate evidence for known RAF/HCC conditions, surface supported conditions that may be missing or insufficiently specified, and capture clinician confirmation when needed.
Quality and Stars performance
Close applicable HEDIS and quality gaps at the encounter instead of chasing evidence after the measurement window. Every unresolved gap is increasingly consequential.
Audit and regulatory readiness
Maintain defensible submission records with FHIR receipts, SHA-256 hashed evidence, and RADV-ready bundles while identifying unsupported conditions before they create audit exposure.
Roster and identity integrity
Reconcile payer rosters against live EHR data before downstream workflows begin, reducing attribution, gap-file, claim, and submission errors at the source.
Encounter readiness
Prepare practices with member-specific gaps, coding opportunities, supporting evidence, campaign priorities, and time-sensitive scheduling needs before the visit.
Administrative efficiency
Reduce chart chase, manual record requests, and reconciliation by receiving more complete clinical data automatically — with SMART on FHIR integration that reduces provider friction.
Three forces raising the stakes for every payer priority
V28 risk adjustment transition
Reduced RAF values are shrinking revenue, increasing the importance of capturing every supported condition with the specificity and evidence available at the encounter.
Star Rating threshold pressure
CMS is raising the performance threshold needed to protect quality bonus revenue. What previously earned four stars may no longer be enough, making every unresolved gap more consequential.
RADV audit intensity
Greater scrutiny and repayment exposure make reconstructed documentation and unsupported conditions increasingly costly. Plans need defensible evidence before an audit begins, not after.
Before, during, and after every encounter
The Intelligence Suite intercepts existing payer–provider data exchange at the moment each event occurs and evaluates whether value is present — before the window closes.
Before the encounter
Appointment scheduled →
Generates a pre-visit brief with open care gaps, RAF/HCC opportunities, supporting evidence, campaign priorities, and relevant pharmacy flags.
Roster conflict detected →
Compares payer and EHR identity data and routes discrepancies for resolution before downstream workflows proceed.
Gap file or payer campaign received →
Identifies affected members, evaluates available clinical evidence, and prioritizes opportunities for upcoming encounters.
During the encounter
Encounter opened →
Presents relevant gaps, supporting evidence, and recommended next steps through a SMART on FHIR application within the clinician's existing EHR workflow.
Coding opportunity identified →
Surfaces potentially supported or insufficiently specified RAF/HCC conditions, presents available evidence, and prompts clinician review while the encounter remains open.
Lab or clinical result received →
Evaluates whether the result closes an applicable measure or supports an open clinical or coding opportunity.
After the encounter
Note signed →
Reconciles which gaps and opportunities were addressed, identifies those that remain open, and flags potentially supported but uncoded conditions for follow-up.
Claim or RAF submission queued →
Confirms member identity and coding completeness, then creates the structured receipt and supporting evidence record.
Measurement deadline approaching →
Flags unresolved gaps, unsubmitted supported conditions, and required follow-up before the opportunity expires.
And more: ADT notifications, Rx fulfillment, referrals, claim denials, roster updates, and emerging clinical events.
Four layers. One complete picture.
MediVu evaluates structured data, clinical notes, inferred signals, and clinical context to build a stronger record of care — giving payers and providers more complete evidence to support submissions, close gaps, and prepare for audit.
Coded evidence
Structured EHR data, diagnoses, procedures, lab results, and claims history.
Narrative evidence
Clinical notes, discharge summaries, and other unstructured documentation reviewed for signals.
Inferred evidence
Clinical signals and patterns detected across the member record and clinical notes.
Clinical context
Specialist reports, lab trends, and cross-encounter clinical history.
Processing stops when sufficient support is found. Findings requiring review are routed for clinician confirmation, and the resulting evidence trail is preserved.
How it delivers makes the difference
Complete
Builds a more complete clinical picture of each member by surfacing evidence and clinical signals individual EHR records miss — combining coded, narrative, inferred, and contextual sources.
Real-time
Delivers prioritized intelligence as events occur, while there is still an opportunity to act — not after the measurement window, not after the claim goes out, not after the audit notice arrives.
Defensible
Creates audit-ready records for supported submissions, including validated evidence, clinician approval timestamps, SHA-256 hashed evidence, and preserved validation history.
Three coordinated products, one shared Intelligence Bridge
Overwatch, Sentinel, and Aegis each serve a distinct audience. All three operate on the MediVu Intelligence Bridge so priorities, evidence, and actionable intelligence reach the right person at the right moment.
Overwatch
Network-wide payer intelligence that monitors the attributed member population and surfaces opportunities across the full lifecycle of every encounter.
- → RAF and HCC opportunity identification
- → HEDIS and Stars gap management
- → RADV audit bundle generation
- → Payer campaign prioritization
- → Network performance and results monitoring
Sentinel
Practice and identity intelligence that confirms member rosters, prepares teams for upcoming encounters, and protects downstream workflows from identity and attribution errors.
- → Roster identity reconciliation
- → Pre-visit encounter briefing
- → Conflict detection and resolution routing
- → Practice and network trend monitoring
- → Downstream workflow protection
Aegis
Clinician-facing intelligence delivered inside the existing EHR workflow—with no new logins, no new portals, and no new habits to build.
- → SMART on FHIR EHR integration
- → In-workflow gap closure prompts
- → Evidence-backed coding opportunities
- → Clinician review and confirmation capture
- → Submission receipt and evidence generation
Achieve your priorities.
Respond proactively to market pressures.
Strengthen revenue and patient outcomes — before the measurement period closes, before chart chase begins, and before the audit arrives.
ONE INTELLIGENCE FOUNDATION
Across the payer-provider continuum
MediVu Intelligence Bridge is the real-time, event-driven foundation connecting payer priorities, live clinical data, and provider workflows — so every opportunity moves continuously from identification to action to supported result.
Payer Intelligence
Monitors the attributed network, applies payer-specific priorities, identifies opportunities and risk, tracks provider engagement, and returns supported results across the network.
Practice Intelligence
Confirms member identity, prepares practices for upcoming encounters, prioritizes open opportunities, and coordinates required follow-up before the patient arrives.
Clinician Intelligence
Presents relevant care gaps, supporting evidence, coding opportunities, and recommended next steps within the clinician's existing EHR workflow — no new logins required.