They are not the same purchase

Reveleer sells to health plans. Pelica sells to the risk-bearing provider organizations sitting on the other side of those contracts. Almost everything else on this page follows from that one fact, and it is the least contestable thing here.

Reveleer's own pages name the buyer for you. Member Management is described as purpose-built for Medicare Advantage plans. Care Gap Manager states that the health plan owns the program and invites provider groups into the program to participate. There is a provider page too, aimed at risk-bearing provider groups, IPAs, ACOs, and integrated delivery networks, naming Epic and athenaOne as its EHR connections. But the program is the plan's.

Pelica's buyer is narrower. A risk-bearing IPA, medical group, ACO, or MSO where six to ten people own a panel of 50,000 to 150,000 members spread across several payer contracts, each with its own portal, its own gap list, and its own submission calendar. Those teams are not short of gap lists. They are short of hours.

What Reveleer actually is in 2026

Reveleer was founded in 2009 as Health Data Vision, a medical record retrieval services business, and renamed itself Reveleer in August 2019. Retrieval is still the spine of the company. What sits on top of it has changed a great deal in three years.

Four product families, roughly:

  • Retrieval and retrospective risk adjustment. Three retrieval lanes on the technology page: digital EHR integration, a secure provider upload portal, and traditional mail and fax. Then diagnosis detection, chase prioritization, suppression logic, and CMS and RADV-IVA submission.
  • Quality. Quality Improvement covers 40-plus HEDIS measures, hybrid and administrative, and a separate HEDIS Audit and Abstraction product handles sampled-member chart chase for hybrid season.
  • Prospective and care gap work. Clinical Intelligence runs pre-visit suspecting off a stated 11,000 clinical indicators plus clinician-authored formulas, delivered through a portal, an EHR overlay, or data exhaust. It came largely from acquisitions: MDPortals in May 2023, Curation Health in October 2024, and Novillus in April 2025.
  • Plan back office. Member Management is eligibility verification, correspondence, election submissions to CMS, premium billing, and revenue reconciliation.

Three launches matter for anyone comparing vendors this year. RADV Audit SaaS shipped in October 2025. EVE Hybrid AI, the diagnosis-suspecting engine built on Google Cloud, launched in January 2026. The Clinical Data Repository, announced April 2026, stores charts once at member level and reuses them across risk adjustment, quality, RADV, IVA, and care management.

So the old shorthand is wrong. Reveleer is not a retrospective chart review company. We got this wrong ourselves: our Navina vs Reveleer comparison said Reveleer was not designed to act in the exam room before the encounter is documented. That was fair in 2024. It is not fair now, and we corrected that page the day we published this one.

Pelica vs Reveleer, dimension by dimension

Every Reveleer cell below comes from a Reveleer product page, a Reveleer press release, or KLAS. Where a number is Reveleer's own claim about itself, it says so.

DimensionReveleerPelica
Primary buyerHealth plans first. Member Management is described as purpose-built for MA plans, and the care gap program is owned by the plan, which invites provider groups to participate. A provider page covers IPAs, ACOs, and IDNs.Risk-bearing IPAs, medical groups, ACOs, and MSOs. Typically 6 to 10 people owning 50,000 to 150,000 members across several payer contracts.
Who operates the outreach channelReveleer routes work to people. Care Gap Manager builds provider packets, tracks follow-ups, and gives provider staff web forms to submit evidence, which route to validators at the health plan. Retrieval outreach by phone, fax, email, and mail is aimed at provider offices to collect records.Pelica's agents do the work. Voice AI calls patients, pharmacies, and prescribers. Computer-use agents work payer portals and EHRs. Both follow up on their own and hand off to a person when a person is genuinely needed.
Event to first contactNo latency figure published on any Reveleer page reviewed on August 4, 2026.ADT-driven transitions-of-care worklists open when the discharge message lands. 5-day follow-up target, and 70%+ of TRC gaps closed within 30 days.
Cross-payer gap consolidationThe Clinical Data Repository consolidates charts at member level across programs inside one plan's enterprise.One canonical member record across claims, EHR, pharmacy, lab, ADT, and payer feeds, spanning every payer contract the group holds. Typically replaces 8 to 15 vendor portals.
Evidence write-backProvider staff submit evidence and attestations through web forms that route to plan-side validators for approval. Reveleer states supplemental data submissions rise 40%.EMR overlay through Epic SMART on FHIR, Athena, and eClinicalWorks. Agents write their notes into the source system, with a full audit trail.
Chart retrieval and abstractionThe origin of the company and still a core strength. Three retrieval lanes including mail and fax. Reveleer states it processes more than 400 million patient records a year.Not a retrieval business. Pelica unifies claims (MMR, MAO-004, MOR, 277CA), EHR via FHIR and HL7, pharmacy PDE, labs, ADT, telephony, and payer SFTP drops into one record.
RADVA dedicated end-to-end product launched October 2025: CMS enrollee data list ingestion, record chasing, HCC validation per payment year, provider attestation, multi-level QA with audit logs, and a CMS-ready submission package.No RADV submission product. Pelica keeps a defensible chain of custody on each captured condition, which is an input to an audit response rather than the response itself.
Prospective suspectingCurrent and credible. Clinical Intelligence plus EVE Hybrid AI, on Google Cloud, with Epic and athenahealth integration and support for CMS V28 and HHS V08.Risk Adjustment copilot: real-time HCC capture, V28 trumping logic, RADV-defensible chain of custody, and 277CA to MOR tracking. Coordination drops from 30 minutes to 3 per member.
Member outreachThe module called Member Management is enrollment, premium billing, and revenue reconciliation. It is not member engagement.One shared outreach queue across quality, pharmacy, care management, and risk, so one member is not called four times in a week by four teams.
Implementation timeNo implementation timeline published on the platform, payer, provider, or module pages reviewed on August 4, 2026. The provider page describes integration as effortless without giving a number.Live in 2 weeks. First copilot in 2 to 4 weeks.
Published compliance postureThe security page names HIPAA compliance and HITRUST CSF certification.SOC 2 Type II and HIPAA, BAA available, tenant isolation, zero-retention LLM agreements, full audit trail. HITRUST in progress.
HEDIS measure engineNone of its own, by design. Reveleer states its quality product integrates with any certified HEDIS engine.None of its own either. Pelica works the gaps a certified engine produces.

Comparison reflects each vendor's publicly stated positioning as of August 2026. Where a row says a figure is not published, that means we looked and did not find one, not that the capability is absent.

Where Reveleer is the better buy

A comparison page with no losses is a page nobody should trust. These are real, and each one is a reason to pick Reveleer over us without a second meeting.

  • Retrieval at scale. Seventeen years of it, including the unglamorous mail and fax lane that plans still need because thousands of small practices still live there. Reveleer states it handles more than 400 million patient records a year and, in the Clinical Data Repository release, 1.2 billion pages annually for 55-plus health plans. Pelica does not do this at all.
  • RADV depth. An end-to-end audit product from the CMS enrollee data list through the submission package. If the trigger for your search is an audit notice, this is not a close call.
  • Hybrid HEDIS season. Sampled-member chart chase, abstraction, auditor-facing QA, and export in the format certified engines expect. That workflow is seasonal, high stakes, and specific, and Reveleer has a product for it.
  • Plan back office. Enrollment, CMS election submissions, premium billing, revenue reconciliation. Pelica has nothing here and should not pretend otherwise.
  • Payer enterprise fit. Reveleer states 70-plus health plan customers and 97% customer retention. Add a Google Cloud partnership for EVE and a delivery center in Chennai opened in March 2025, and you have the procurement, security review, and support scaffolding a large plan expects to find.
  • Prospective is no longer a gap. EVE Hybrid AI plus the Curation Health rules base makes Reveleer a serious prospective vendor as of January 2026.
If your buying trigger is a RADV notice, a hybrid HEDIS season, or a chart retrieval backlog at plan scale, Reveleer belongs on the shortlist. If your buying trigger is that the gap list is already accurate and nobody has time to work it, that is a different purchase.

What the independent evidence actually shows

Less than buyers expect, for either of us. Reveleer has no G2 product page, its Capterra listing carries zero reviews and no rating, and no meaningful TrustRadius review corpus surfaced. The one independent buyer-derived signal is KLAS, which lists a segment score of 75.0 for the Reveleer Risk Adjustment Solution, flagged as limited data and drawn from four unique organizations, against a category market average of 75.5 and a software average of 80.1, for the data window August 2025 to August 2026. Four respondents is a signal, not a rating, and Reveleer holds no Best in KLAS award in that category. Pelica has no KLAS rating at all, so we are in no position to make more of that number than it deserves.

Neither company publishes pricing. Neither Capterra nor any procurement aggregator we checked lists a Reveleer starting price, free trial, or free tier as of August 2026. Pricing on both sides is quoted per engagement.

The question the table does not settle: who does the work

Reveleer published the best evidence for this argument itself. Its 2026 State of Technology in Value-Based Care report, produced with Mathematica from a Harris Poll of 200 senior payer and provider decision-makers fielded in March 2026, found that 100% report AI adoption while 94% of providers still rely on manual value-based-care processes. Ninety-three percent report vendor overpromising. Only 13% of payers and 29% of providers feel well prepared for current CMS requirements. Jay Ackerman, Reveleer's CEO, put it this way: the debate over whether healthcare organizations should adopt AI has ended, and the challenge now is accountability.

That gap between adoption and operations is the whole argument. Software that identifies a gap and software that closes one are priced alike and sold alike. They do different work.

A precise note on outreach, because the loose version of this claim is wrong. Reveleer's EVE technology page lists an AI voice agent among EVE's components. Reveleer does not publish what that agent does, whom it calls, or which module it ships in, so nobody outside the company should characterize it. What Reveleer does publish is a provider-facing outreach model: record requests by phone, fax, email, and mail, provider packets routed to office staff, and web forms that send evidence to plan-side validators. We have not found a published member-facing outbound calling workflow.

Pelica's outreach model is the thing we sell. Voice agents call the patient, the pharmacy, and the prescriber, work through refusals and voicemail, and come back the next day. Computer-use agents log into the payer portal and the EHR and do what a coordinator would do with a mouse. A human gets the call when a human is actually required.

70%+
Transitions-of-care gaps closed within 30 days
100%
Team adoption at the largest IPA in the country
~10 hrs
Given back per user per week

When Pelica is the better fit

When the constraint is capacity, not visibility. A risk-bearing IPA or medical group with a small team and a large panel, working gaps that arrive from four or five payers in four or five formats, with nobody left to make the calls.

The numbers we can stand behind: 96 to 98% adherence on the three triple-weighted Part D measures, roughly 90% of BCS and KED gaps closed in-year, 70%+ of transitions-of-care gaps closed within 30 days, risk adjustment coordination down from 30 minutes to 3 per member with 2 to 3 times the members covered by the same team. At our flagship customer, a physician-led IPA in New York running risk on about 175,000 patients, adoption reached 100% and teams got back roughly 10 hours per user per week. Deployments go live in about two weeks.

The honest limits, in one place: no chart retrieval network, no RADV submission product, no Medicare Advantage back office, no certified HEDIS measure engine, no KLAS rating, and a much smaller company than Reveleer. If any of those are what you are shopping for, we are the wrong call.

When a plan and its provider groups run both

This is more common than the versus framing suggests, because the two products sit on opposite sides of the same contract. A Medicare Advantage plan runs Reveleer for retrieval, hybrid HEDIS abstraction, and its RADV response. The IPAs and medical groups delegated risk under that plan run Pelica to work the gaps and suspects that come back down, across that plan and the other four they contract with.

Neither vendor's economics depend on the other losing. The plan's problem is getting records and defending submissions. The group's problem is that an accurate gap list still has to be worked, and nobody has the hours. Reveleer's Care Gap Manager is the interesting seam: it is designed to route work into provider offices, which is exactly the work a provider-side execution layer is built to absorb.

How to choose

Four rules, keyed to what actually made you start looking.

  1. An audit notice arrived. Reveleer, or Inovalon. Pelica does not compete for this.
  2. Hybrid HEDIS season is coming and you are a plan. Reveleer, or one of the certified measurement vendors. Chart chase at sample scale is a retrieval problem.
  3. You are a plan with a retrieval backlog or duplicate chart spend. Reveleer, Datavant, or another retrieval vendor. Compare on cost per retrieved chart and on how often the same record gets pulled twice. Our Reveleer alternatives guide sorts the field by job.
  4. You are provider-side, the gap list is fine, and the work is not getting done. That is the execution purchase, and the shortlist looks nothing like the one above. Ask every vendor a single question: after the gap appears, who places the call? If the answer is your staff, you are buying a worklist. The same test sorts the Innovaccer alternatives field.

Sources