Navigating False Credits: Unveiling Causes and Solutions
The top 5 causes for false credit balances and what to do about them. False credit balances in healthcare accounts receivable are more than just numerical errors; they symbolize a daunting challenge that disrupts financial accuracy and operational efficiency. In a world where precision is paramount, these inaccuracies cast shadows of doubt, consuming valuable resources, […]
Looking Back: A 2023 Retrospective of Denial Industry Trends
As we look back on 2023, it’s evident that the denial industry has experienced a significant increase in claim denials. Nearly half of providers indicated that they saw a rise in denials compared to 2022. Advent Health Partner’s data supports this by indicating an increase of 30% more denied dollars, year over year, on a […]
CAVO® DRG Predict Demo
CAVO® DRG Predict Video Series | CAVO Demo Join Advent Health Partners’ Director of Client Success, Shane Mayfield, and Clinical Product Director, Julie Scates, BSN RN, as they introduce and demo CAVO for DRG Predict. This demo will show how CAVO utilizes automation and predictions to benefit the user and their team, leveraging risk scores, […]
TREND Health Partners Acquires Advent Health Partners
COCKEYSVILLE, Md.–(BUSINESS WIRE)–TREND Health Partners (“TREND”), a rapidly growing provider of healthcare credit balance management and payment accuracy solutions, announced today that it has acquired Advent Health Partners, Inc. (“Advent”). This strategic combination solidifies TREND’s position as a leading AI-driven payment accuracy and revenue integrity platform for healthcare payers and providers Founded in 2010, Advent’s cross-functional team […]
Uncover the Hidden Potential of In-House Clinical Appeals
Over half of U.S. hospitals ended 2022 with a negative margin as increased expenses quickly surpassed revenue growth. Among the issues heavily affecting the industry are claim denials—they have emerged as one of the most critical financial challenges for healthcare providers to manage, ultimately impacting the financial well-being of both healthcare providers and patients. Denied […]
Artificial Intelligence to Support DRG Audits
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 focus on the accuracy of medical coding, clinical DRG audits take a broader approach by analyzing […]
Native American Heritage Month 2023: Honoring a Rich Cultural Legacy
Native American History Month 2023 Native American Heritage Month is observed every November. The significance lies in its ability to educate others about the culture and history of Native Americans. It is a time to learn about their traditions, customs, and beliefs and recognize the challenges that Native Americans have faced and continue to face. […]
NLP in Medical Record Review
Legacy Review The traditional medical record review process has long been plagued by challenges, including the obstacle of the sheer volume of medical records that need to be reviewed. Hundreds of millions of patient records are generated daily, making it a daunting task for medical professionals to review and extract relevant information manually. The review […]
Artificial Intelligence in DRG Review: Streamlining Reviews and Enhancing Efficiency
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 review process, improve accuracy, enhance efficiency, and better manage the cost of quality care for their constituents. Building the Model: Preprocessing […]
Saving Time and Reducing Cost with cNLP
The review of medical records is critical in determining whether claims are billed and reimbursed accurately, and DRGs are the primary methodology for both hospital billing and health plan reimbursement. Although the overall methodology is well constructed and documented, several challenges are associated with a DRG review due to the reliance on the unstructured medical […]