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 | Nov 8, 2023 | Article, CAVO, CAVO AI, Health Plans & Partners
Overview of DRG Reviews DRG reviews play a crucial role in ensuring accurate reimbursement for healthcare services. The two main types of DRG reviews, clinical DRG audits, and coding reviews bring different approaches to accurate reimbursement. While coding reviews...
by Trend HP | Oct 6, 2023 | Article, CAVO, CAVO AI
Legacy Review The traditional medical record review process has long been plagued by challenges, including the obstacle of the sheer volume of medical records that need to be reviewed. Hundreds of millions of patient records are generated daily, making it a daunting...
by Trend HP | Sep 8, 2023 | CAVO, CAVO AI, Client Success, Health Plans & Partners
A multi-state health plan engaged TREND Health Partners to increase their volume of itemized bill reviews, and by leveraging TREND’s medical review technology, CAVO®, increased their total financial value by 61% after 18 months. When the payer initially engaged...
by Trend HP | Sep 7, 2023 | Article, CAVO, CAVO AI, CAVO for Payment Integrity
Artificial Intelligence has made significant advancements to payment integrity and the DRG reviews process. By leveraging AI technologies, such as natural language processing (NLP) and machine learning (ML) algorithms, healthcare organizations can streamline the...
by Trend HP | Aug 18, 2023 | Article, CAVO, CAVO AI
The review of medical records is critical in determining whether claims are billed and reimbursed accurately, and DRGs are the primary methodology for both hospital billing and health plan reimbursement. Although the overall methodology is well constructed and...
