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 | 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 | 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 Trend HP | Sep 20, 2021 | Article, CAVO, CAVO for Payment Integrity, Health Plans & Partners
Introduced in the 1980s, a DRG is a crucial component of today’s healthcare system. Most DRGs today are reviewed in a post-pay environment – providing challenges for both provider and payer alike. For the provider, the post-pay DRG review comes with...
by Trend HP | 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,...