HomePlatformRisk and quality

Import claims and pharmacy files from each payer. Newbula scores risk, quality and cost, and turns every open gap into a list your team or an AI agent can call.

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Quality and riskMeasurement year 2026
78%
Gap closure
214 open, 96 in outreach
1.184
Average RAF, up 0.06 since January
Glycemic status
81%
Blood pressure
69%
Breast cancer screening
74%
Statin adherence
86%
MemberRAFSuspectedNext step
T. Brennan1.42CHF, CKD 3Visit booked
S. Varga0.96Diabetes w/ complicationsCall queued

How it works

Your team decides what happens. Newbula does the repetitive part and records everything.

1

Import payer files

Claims, pharmacy and eligibility files mapped for each payer.

2

Score

RAF, HCC, HEDIS, Part D adherence and MLR calculated automatically.

3

Reach

Open gaps become calling campaigns and staff worklists.

4

Report

Share financial and quality reports with payers and your board.

What changes for your team

The work stays the same. The hours it takes do not.

Gaps found in the last quarterReports arrive when there is no time left to act.
Measures update as each file is imported, so gaps are visible all year.
Reports that stop at a numberSomeone still has to call every member.
Each gap list becomes an outreach campaign in one click.
Files in five formatsEach payer sends data differently.
Mappings per payer turn every file into the same measures.

Everything included

Part of the same platform, so every result lands on the same patient record.

Risk adjustmentMRA and RAF scores with the trace behind each one.
HCC captureSuspected conditions queued for documentation at the next visit.
HEDIS and StarsMeasure rates against your targets, updated every import.
Part D adherenceMembers falling behind on statins, diabetes and blood pressure drugs.
MLR and financialsMedical loss ratio by payer and month, with the drivers underneath.
Digests and shared reportsScheduled summaries and time-limited links for payers.

Works with

Each tool reads and writes the same record.

AI voice agentsCalls, check-ins and callbacks in English and SpanishLearn moreHealth plansRisk, quality and member outreachLearn moreFax and email inboxEvery document read, matched and routedLearn more

Give your team the day back.

Bring one workflow, like reminder calls or fax intake. We'll walk through it in Newbula with your data.

Request a demoExplore the platform
Or write to hello@newbula.ai