Healthcare Interoperability Benefit 2: Reduced Admin Burden & Overall Healthcare Costs
Here at Advent, our expertise as a solution provider in the healthcare ecosystem is to convert clinical information to FHIR® standard and provide an open API that allows its exchange between payers and providers, effectuating efficiency and reduced administrative costs in the claims process. We understand the nuances of the healthcare claims review process and […]
Healthcare Interoperability Benefit 1: Streamlined Data Exchange Between Health Plans, Healthcare Providers, and Patients
According to a study conducted by Johns Hopkins, 44% of medical error deaths were preventable. As the CMS Mandate for healthcare interoperability approaches, the requirements come not a moment too soon for an industry lacking effective data exchange capabilities. Medicine and treatments have advanced tremendously through the years, as we’ve witnessed with the rapid development […]
Why Expanding Into Outpatient IB Pre-Payment Makes Sense… and Money
Health plans are working harder than ever to avoid inaccurate claims payments upfront to minimize the cost and resources required to recover overpayments 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 […]
Shifting to Pre-Pay Itemized Bill Reviews
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, record keeping, and administrative costs for both […]
Itemized Bill Review Challenges & Solutions
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 […]
Health Plan Challenges in the DRG Claims Review Process
Combating Common Health Plan Challenges If you’re an executive at a health plan, you likely spend a fair amount of time and energy thinking about minimizing provider abrasion, but what about the health plan challenges you face on the payer side of the equation? Health plans have long struggled with inefficiencies that compromise provider relationships […]
50%+ Faster DRG Claim Reviews [WEBINAR]
WEBINAR REPLAY 50%+ Faster DRG Claim Reviews Health plan industry veterans share three best practices for getting 50%+ faster DRG claim reviews. Hear recommendations you can apply for almost immediate productivity increases. Create a scalable DRG review process by applying three principles Filter claims with the highest potential to align your team’s time Reduce cost […]