by | Jul 12, 2022 | Article, CAVO, CAVO AI, Health Plans & Partners
Line-by-line, nurses and coders meticulously review itemized bills during the IB review process in search of findings and savings. This time-consuming review requires focused attention to search through potentially hundreds of pages and thousands of line items. The...
by | Jun 27, 2022 | Article, CAVO, CAVO AI, CAVO for Payment Integrity, Health Plans & Partners
The administrative burden is difficult to manage in the DRG review claims process. With millions of patients being treated on a daily basis, the sheer number of medical records is overwhelming and can block health pans from being able to move into pre-pay DRG reviews....
by | Sep 2, 2021 | Article, CAVO, CAVO AI, CAVO for Payment Integrity, Health Plans & Partners
Let’s face it: the modern-day DRG review process is laborious, cumbersome, and quite often…exhausting. Every step from requesting the record to exchange, to preparing the document to review, and then notifying the provider of downgrades or changes takes time, effort,...
by | Aug 30, 2021 | Article, CAVO, CAVO AI, CAVO for Payment Integrity, Health Plans & Partners
So you’ve selected the DRGs that you want to review…now what? Next in the process is the record exchange. One of the biggest hurdles to moving DRG reviews into the prepay process is the actual record exchange between payer and provider. Traditionally, all too often,...
by | May 26, 2021 | Article, CAVO, CAVO AI, Health Plans & Partners
Hours, days, and sometimes weeks or more can be required for a payer to review and audit a medical itemized bill (IB). From outpatient procedures to long hospital stays, there are millions of insurance claims submitted for review daily. The process is time and...
