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 […]
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 […]
CAVO IB Predict: The Present Future of Itemized Bill Review
Estimated administrative costs in the U.S. healthcare system related to billing and insurance hit $496 billion in a 2019 report released by Centers for Medicare and Medicaid Services. Central to this cost riddled with excess is the claims process between payer and provider, including claims submissions. Wherever there’s excess, there’s an opportunity to “trim the […]
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 […]
Bringing The Itemized Bill Review Process In-House: 3 Key Steps
Hours, days, and sometimes weeks or more can be required for a payer to review and audit a medical itemized bill (IB). From outpatient procedures to long hospital stays, there are millions of insurance claims submitted for review daily. The process is time and resource consuming, yet it is essential to the payer-provider relationship of […]
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 […]
Advent Health Partners Presents: CAVO® Itemized Bill Reviews
Medical Record Review Technology Platform adds CAVO® Itemized Bill Reviews and Expands Search Tool with Clinical Terms and Drug Names December 16, 2019 (Nashville, TN) – Advent Health Partners, Inc. has unveiled an additional module, CAVO® Itemized Bill Reviews, that intakes itemized bills (IBs) and auto-converts them into sortable and filterable data. Instead of sifting through the […]