An Enterprise Medical Record Review Platform
Directly access EMR data and images
Digitally review, sum, sort, and share IBs
Immediately decrease cost containment spends
Increase productivity by 300+%
What is CAVO Payer?
CAVO Payer is an enterprise platform enabling health plans to aggregate imaged medical record documents that are then instantaneously searchable due to our proprietary OCR medical record technology. To maximize efficiencies, reviewers can create “findings” summaries directly within the platform. Plus, CAVO’s open API enables reporting on both structured and unstructured data – which lends itself to detailed medical record review data that can be used to create or enhance payer’s NLP or machine learning initiatives.
What if your health plan could…
Increase payment integrity productivity by 300+% I Expand audits I Immediately decrease cost containment spends
Digitally review, sum, sort, and share IBs I Directly access EMR data and images
Health plans leverage our medical record review platform for immediate ROI in areas including:
- Leverages clinical time by improving your payment integrity and/or utilization review team’s productivity and timeliness during medical record reviews for medical necessity/level of care – while maintaining quality.
- Nurses can share only findings from their denial appeal reviews – and further streamline doctors’ time with CAVO’s annotate, highlight, and notes functionalities.
- Facilitates escalation of medical record reviews to clinicians.
- Typically surfaces the DRG information needed to make a coding determination regarding a provider appeal within 1-2 searches.
Itemized Bill (IB) Reviews
- Captures data from original itemized bills and displays it within a filterable format, enabling sorts by revenue codes, dates, and item descriptions.
- Generates a report automated with correct header data and items marked within the platform to efficiently share with providers when responding to denial appeals.
Fraud, Waste & Abuse (FWA) Reviews
- Searches across FWA cases or through specific provider cases – including images – to prioritize suspects.
- Builds custom reports to surface medical record review trends by providers, DRG codes, etc.
- Delivers a scalable solution for FWA audits, regardless of database size or total records.
CAVO Results Calculator
Health plan users experience a 300+% average productivity increase. Input your payment integrity or utilization review department’s basic stats to estimate your particular health plan’s medical record review productivity lifts.
Does your health plan have an initiative to increase itemized bill reviews this year?
Do you outsource itemized bill audits – or parts, such as itemized bill transcription into an Excel spreadsheet?
Increase IB review efficiencies by 5X+ with CAVO
CAVO Service: Itemized Bill Reviews
This technology intakes itemized bills (IBs) and re-formats them into filterable data, enabling you to:
- Sort and filter by revenue codes, dates, and item descriptions.
- Easily make line-by-line accept/reject decisions with customizable reason codes for each.
- Efficiently perform quality assurance of the CAVO IB Tab by comparing against the original hospital bill line.
- Auto-sum totals in real-time – including line detail of adjusted amounts.
- Create reports with auto-generated headers.
What Our Clients Are Saying
“Not only can reviewers easily pull up a patient’s entire file on the computer screen, now with a few keystrokes they can search a 10,000-page medical record and see all references to specific data points within seconds…[our] ultimate goal in switching to CAVO’s technology is to zero out hard copy records altogether”
Manager, Payment Integrity
BEST-IN-CLASS MEDICAL RECORD REVIEW TECHNOLOGY
OCR & SEARCH
CAVO’s proprietary full text search functionality makes indexing and/or categorizing medical records unnecessary
How CAVO Works for Payers
AGGREGATES I ANSWERS I ASSEMBLES I ANALYZES I AUTOMATES
VIDEO SPOTLIGHT: CAVO ANSWERS
Perform Medical Record Reviews More Efficiently
3 REASONS TO USE CAVO
CAVO transforms the medical claims review process by intaking medical record documents and images to create searchable data with our proprietary OCR.
Use CAVO to create “findings” summaries within the imaged medical record. The result is an efficient packet including only data relevant to that claim.
Leverage CAVO to automate audit segments today while facilitating future machine learning for claims reviews.
By the Numbers:
A CAVO Client Success Story
A CAVO Client Success Story
Payment Integrity Solution for Medical Record Reviews
While many technology companies specialize in healthcare, CAVO Payer is one of the few technologies specifically designed for health plan payment integrity and utilization review departments—delivering a comprehensive solution to inefficiencies throughout the medical claims review process. Our platform’s goal is to streamline the medical record review process, increasing appropriate reimbursement efficiencies.