by Trend HP | Apr 2, 2024 | Article, CAVO, CAVO for Payment Integrity, Health Plans & Partners, Interoperability
Payers and providers in the United States spend approximately $496 billion annually on billing and insurance-related costs (BIR). Another study by the National Academy of Medicine estimates that the U.S. spends about twice as much as is necessary on BIR costs. These...
by Trend HP | Mar 26, 2024 | Article, CAVO, CAVO for Payment Integrity, Health Plans & Partners
Health plans are working harder than ever to avoid inaccurate claims payments upfront to minimize the cost and resources required to recover overpayments on the back end. Although pre-payment itemized bill review (IBR) is still in its infancy stages of mass adoption,...
by Trend HP | Mar 19, 2024 | Article, CAVO, CAVO AI, Health Plans & Partners
Estimated administrative costs in the U.S. healthcare system related to billing and insurance hit $496 billion in a 2019 report released by Centers for Medicare and Medicaid Services. Central to this cost riddled with excess is the claims process between payer and...
by Trend HP | Mar 12, 2024 | Appeal Management, Article, Health Systems & Hospitals
Over half of U.S. hospitals ended 2022 with a negative margin as increased expenses quickly surpassed revenue growth. Among the issues heavily affecting the industry are claim denials—they have emerged as one of the most critical financial challenges for healthcare...
by Trend HP | Feb 20, 2024 | Appeal Management, Article, Health Systems & Hospitals, Revenue Integrity Consulting, Utilization Management
As the volume of denials continues to increase, hospitals and health systems need a more proactive approach to denial management and prevention. Providers are encouraged to move from a denial management framework to a denial prevention framework to capture appropriate...
by Trend HP | Feb 20, 2024 | Article, CAVO, Health Plans & Partners
Drug costs have steadily risen in the United States since the 1980s. Payers are spending upwards of $2 billion on prescription drugs every year, and pharmaceutical billing is becoming more and more important as the price of prescription drugs rises. In the past three...