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 […]
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 […]
Medication Cost Discrepancies in Healthcare Bill Audits & Reviews
Drug costs have steadily risen in the United States since the 1980s. Payers are spending upwards of $2 billion on prescription drugs every year, and pharmaceutical billing is becoming more and more important as the price of prescription drugs rises. In the past three years, half of all drugs covered by Medicare have increased above […]
DRG Validation and an AI Approach to Sepsis
CAVO® DRG Predict Video Series | DRG Validation In this video series, our Principal Scientist Lance Hahn, Ph.D., and our Machine Learning Engineer, Cam Carver, discuss medical record documentation and technology, including machine learning, natural language processing, artificial intelligence, named-entity recognition, and how these technologies are used for DRG validation and how to identify sepsis […]
Sepsis Diagnosis: The Impact of Age and Comorbidities
CAVO® DRG Predict Video Series | Sepsis Diagnosis Advent Health Partners Clinical Product Director, Julie Scates, BSN RN, speaks with Clinical Products Specialist Amanda Curran regarding the impacts of age and comorbidity on a sepsis diagnosis. This builds on our discussion in part one about how the differences between sepsis definitions result in variance in […]
Sepsis-2 vs Sepsis-3 Criteria: Their Impact on Medical Records & Claims
CAVO® DRG Predict Video Series | Sepsis and DRG Validations Join Advent Health Partners’ Clinical Product Director, Julie Scates, BSN RN, and our VP of Clinical, Deborah Horne, as they discuss clinical diagnostic criteria utilized for clinical DRG validations. This presentation will review how the differences between sepsis definitions result in variance in billing and […]
Solutions for Common Pain Points in the Pre-Pay DRG Review Process
Introduced in the 1980s, a DRG is a crucial component of today’s healthcare system. Most DRGs today are reviewed in a post-pay environment – providing challenges for both provider and payer alike. For the provider, the post-pay DRG review comes with considerable abrasion, often requiring service fees already collected to be returned to the payer […]