The Best Way To Optimize Your EMR
Providers today are better informed and are prepared to take on more challenges due to the information and flexibility that EMRs provide, yet this technological tool is not without its downfalls. EMRs are notoriously hard to navigate, especially when performing manual reviews. Being a strong source of information is detrimental when people have to manually […]
Improving Hospital Denials by Department
A hospital’s denial issues vary based on the organization, and because of this, sometimes pinpointing potential denials can be difficult. Moving from a management to a prevention model is a slow process, and issues can potentially arise if denials by the department are overlooked. However, the point of denial prevention is to move towards a […]
Increase IB Review Findings and Savings With CAVO®
Line-by-line, nurses and coders meticulously review itemized bills during the IB review process in search of findings and savings. This time-consuming review requires focused attention to search through potentially hundreds of pages and thousands of line items. The volume of itemized bills generated daily throughout the healthcare system makes efficient and complete review impossible if […]
First Steps for a Denial Prevention Framework
According to U.S. Healthcare Denial Management Market, a study conducted by Research and Markets, in 2021, the U.S. healthcare denial management market size was valued at $3.57 billion. By 2027 it’s expected to grow an additional 66% and reach $5.94 billion. Denial management can leave millions, if not billions, of dollars on the table if […]
Advent Health Partners’ CAVO® Net Promoter Score® Results
Advent Health Partners is excited to share our Net Promoter Score®, where we asked our clients and partners to discuss their experiences using CAVO® and working with the CAVO support team to streamline their medical claims review processes. With a Net Promoter Score® of 80, Advent blew the average 2022 score for B2B Software & […]
Shifting the Focus from Denial Management to Denial Prevention
As the volume of denials continues to increase, hospitals and health systems need a more proactive approach to denial management and prevention. Providers are encouraged to move from a denial management framework to a denial prevention framework to capture appropriate reimbursement. This will decrease time to revenue by shifting from management and appeals into data, […]
Increase DRG Review Productivity for Your Staff
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. Consider that the vast majority of DRG reviews are still […]
Increasing Efficiency of Claims Review Teams
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 required for each scenario will help your organization implement a more efficient claims review process and […]
Medical Record Review: Efficiently Obtaining Medical Records and IBs
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 team used to obtain medical records and itemized bills. The majority of respondents […]
Implementing Machine Learning and NLP for Review Processes
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 modifications itself. Natural language processing (NLP) looks for variants in language. For example, myocardial infarction and heart […]