IB Predict: The Present Future of Itemized Bill Review

IB Predict The Present Future of Itemized Bill Review FI

Estimated administrative costs in the U.S. healthcare system related to billing and insurance hit $496 billion in a 2019 report released by Centers for Medicare and Medicaid Services. Central to this cost riddled with excess is the claims process between payer and provider, including claims submissions. Wherever there’s excess, there’s an opportunity to “trim the […]

Why Expanding Into Outpatient IB Pre-Payment Makes Sense… and Money

Advent Health Partners IB Pre-Payment

Health plans are working harder than ever to avoid inaccurate claims payments upfront to minimize the cost and resources required to recover over-payments on the back end. Although pre-payment itemized bill review (IBR) is still in its infancy stages of mass adoption, it is proving to be an effective method of helping plans avoid post-payment […]

Making the Shift to Pre-Payment of Itemized Bills

Close up of a bill

According to the Center for American Progress, payers and providers in the United States spend approximately $496 billion annually on billing and insurance-related costs (BIR). Another study by the National Academy of Medicine estimates that the U.S. spends about twice as much as is necessary on BIR costs. These high costs include claims submissions, billing, […]

Bringing The Itemized Bill Review Process In-House: 3 Key Steps

Close up of bills

Hours, days, and sometimes weeks or more can be required for a payer to review and audit a medical itemized bill (IB). From outpatient procedures to long hospital stays, there are millions of insurance claims submitted for review daily. The process is time and resource consuming, yet it is essential to the payer-provider relationship of […]

Health Plan Itemized Bill Review Challenges & Solutions

Solving common IB review challenges

CHALLENGES – Health Plans SOLUTIONS – CAVO IB Reviews CHALLENGE DESCRIPTION FUNCTIONALITY RESULTS Accessing accurate data Those beginning to utilize other technologies to attempt IB data capture are experiencing limited success with accuracy. Automatically extracts information from thousands of IBs. Enables efficient QA with confidence scores and click functionality that opens the corresponding IB page. Delivers […]