Plan Client Success – CAVO Prepay Itemized Bill Reviews

Nurse working with chart in hand

/ PREPAY REVIEWS / ITEMIZED BILL REVIEWS /   Regional Health Plan Decreases Pre-Pay Hospital Bill Review Time by 500+% Per Case    THEN   This regional health plan has an internal team of RNs performing hospital bill pre-pay reviews. Nurse reviewers previously either:  requested the itemized bill (IB) directly from the provider based on […]

Plan Client Success – CAVO Prepay DRG Reviews at Regional Payer

Nurse working with chart in hand

/ PRE-PAY / DRG /   Regional Health Plan’s Pre-Pay DRG Review Team Uses CAVO to Increase Productivity by 200%   THEN   RNs performed DRG validation reviews primarily from providers’ EMRs. Reviews were a page-to-page comparison (often averaging 500+ pages per case) within slow systems with cumbersome navigation. Once RNs located decision information, they […]