by | 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 | 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 | 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 | 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...
by | 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 | Sep 8, 2023 | Article, Case Study, 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...
