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 & […]
National Managed Care Payer Saves Over $2 Million in 10 Minutes
A National Multiline Managed Care Payer serving as a central intermediary for government-sponsored and privately insured healthcare programs needed to audit one of their larger itemized bills. The extensive audit would be a time-intensive process involving a variety of formats and long documents. To help optimize the process for speed, efficiency, and accuracy, the Managed […]
Plan Client Success – CAVO DRG Validation Client
/ PRE-PAY / DRG / Northeastern Regional Health Plan Covering 1M+ Lives Advances DRG Nurse Review Team Productivity using CAVO DRG Validation THEN → Chasing the Records Before CAVO DRG Validation, the record intake team gathers the medical records, depending upon facility, by: Utilizing third-party electronic delivery services, Obtaining encrypted disks from the facility, Accessing […]
Plan Client Success – CAVO Prepay IB Reviews
/ PREPAY REVIEWS / ITEMIZED BILL REVIEWS / Regional Health Plan Decreases Pre-Pay Hospital Bill Review Time by 500+% Per Case Using IB Reviews THEN This regional health plan has an internal team of RNs performing hospital bill pre-pay IB reviews. Nurse reviewers previously either: requested the itemized bill (IB) directly from the provider based on […]
Plan Client Success – CAVO Cost Containment Readmission Reviews
/ POST-PAY / Cost Containment Readmission Reviews Unit Experiences 6:1 ROI During CAVO® Kick-Off Training THEN Client reviewers had to first locate the records associated with the case. Next, reviewers located appropriate documentation within the case (e.g., ED notes, Admission notes, H&P) to find presenting symptoms and reasons for admission. Nurses then pulled up their […]
Plan Client Success – CAVO Post-Pay DRG Validation
/ POST-PAY / DRG / Large National Payer’s Post-Pay DRG Validation Team Achieves 300+% Productivity Increase with CAVO THEN This large national payer applies enterprise rules, edits, and analytics to all post-pay DRG claims to pinpoint “suspects” for potential overpayment, which are then reviewed by a team of RNs. Analytics were performed on claims that […]
Plan Client Success – CAVO Pre-pay DRG reviews at Regional Payer
/ 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 created screenshots and […]
Case Study: Accelerating Medical Necessity Reviews With CAVO®
The Client A health plan is reviewing a medical necessity claim for a 50-year-old male with a neurostimulator placed for pain control related to chronic back pain and right lower extremity numbness. He is a former police officer injured while on duty with nine subsequent back surgeries resulting in post-laminectomy pain syndrome. He now requires […]