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 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 […]