Case Study: AI Technology for Itemized Bill Review Optimization
A multi-state health plan engaged Advent Health Partners to increase their volume of itemized bill reviews, and by leveraging Advent’s medical review technology, CAVO®, increased their total financial value by 61% after 18 months. When the payer initially engaged with Advent, their ten full-time team members manually reviewed 7,500 claims annually. After implementing CAVO into […]
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 […]
Shifting DRGs ‘to the left’
DRGs play an important role in the healthcare landscape; their significance, challenges, and potential to enhance revenue integrity programs in an ever-evolving market are unlike other patient categorization systems. How a payer approaches DRGs can reduce administrative burdens and refine provider relationships, and when combined with pre-pay claim review tools, they can be transformative to […]
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 […]
Introducing: A Superior Client Experience
The New CAVO Interface Advent Health Partners is excited to unveil the latest release of CAVO®— featuring new, powerful features to enhance the CAVO experience. These features will enable greater flexibility among users, increase the power of individual modules, and use cases facilitating the exact functions and descriptions users need to be successful. This release […]
Five Rules for Successful AI Implementation
Artificial intelligence is complex, but utilizing it within your organization to leverage its benefits doesn’t have to be. Join Advent Health Partners’ resident expert and Chief AI Officer, Dr. Robert Coop, as he explains the concept of artificial intelligence in healthcare and the five rules of AI implementation in an easily understandable way. Why does […]
2022 CAVO® Client Experience Highlights
Going into 2023, Advent Health Partners remains committed to a high-quality, responsive, in-house client experience team and backs it up with measured proof. Outsourcing can be less client-focused and lead to low client satisfaction, lost productivity, and lost revenue. With a 100% U.S.-based support team, Advent’s clients receive faster and better support since our team […]
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 […]
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 & […]
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 […]