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Payment Integrity

Get payments right the first time with AI-enabled technology.

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Denial Management

Minimize the impact of denials through payer-provider collaboration.

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Credit Balance

Reduce overpayments and the administrative burden associated with credit balances.
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Increasing Efficiency of Claims Review Teams

by | Jun 9, 2022 | Article, CAVO, Health Plans & Partners, Payer Video, Video

In 2020, insufficient documentation accounted for 63% of all improper payments, followed by incorrect coding (16%), medical necessity (11%), and no documentation (4%), equating to a $25.74 billion loss of revenue. Knowing and having strict standards for what is...

Medical Record Review: Efficiently Obtaining Medical Records and IBs

by | Jun 2, 2022 | Article, CAVO, Health Plans & Partners, Payer Video, Video

Solving medical record review challenges can be similar to a game of Tetris – you have to manage your resources carefully to productively complete medical records and itemized bill reviews properly. A survey we issued recently asked 450 people what method their...

Implementing Machine Learning and NLP for Review Processes

by | May 25, 2022 | Article, CAVO, Health Plans & Partners, Payer Video, Payer Webinar Replay, Video

Machine learning (ML) isn’t just an algorithm that queries information. Machine Learning learns and adapts over time through a data feedback loop. Normal queries require human intervention to capture behavior changes, whereas machine learning recognizes this and makes...

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