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Our Story

A healthcare claims review solutions technology company solving clinical and coding challenges

Advent Health Partners was founded as an outsourced review vendor in 2010 in Nashville. As our business grew, the Advent healthcare claims review solutions team of registered nurses, credentialed coders, and business analysts spent the majority of their time sifting through medical record documentation trying to find decision data – instead of making decisions. Our team began building solutions to increase review efficiencies and pinpointing process improvement opportunities at both health plans and hospitals.

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Performed reviews and proactively addressed growth challenges
  • Added staff and evaluated third-party technologies
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Built in-house, review-specific technology
  • Developers shadowed and interviewed the Advent review team
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Added plan and provider solutions teams
  • Focus on use cases specific to that healthcare business
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Continually building technological solutions
  • Drive process efficiencies and appropriate reimbursements

Today, we share our story, technology, and best practices with plans, providers, and partners to accelerate appropriate reimbursement and increase review team productivity.

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  OUR SOLUTIONS

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Plans

The CAVO® technology suite solves common payer claims review challenges: direct access to hospital EMR data, advanced search capabilities for medical records and itemized bills, and application of machine learning to review prioritization of charges.

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Interoperability

Our healthcare interoperability solutions deliver seamless flow of clinical data using the HL7® FHIR® standard between health plans and healthcare providers, increasing collaboration opportunities and lessening administrative burdens.

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Providers

Apello enables efficient and timely appeals as provider denial appeal teams surface decision data, apply industry and payer contractual guidelines, and assemble packets. Our solutions team also performs a spectrum of denial prevention and denial management outsourced services.

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OUR VIEW

MISSION

Drive appropriate reimbursement

and improve operational efficiencies through

expertise

technology

collaboration

VISION

MAXIMIZE REVIEW EFFICIENCIES

by streamlining processes and removing barriers between

health plans

healthcare providers

partners

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Our Security

We meets the highest standards requirements for information protection of clients’ sensitive data.

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Our Leadership Team

Previously decision makers at plans, providers, and various healthcare organizations, our leadership realized health plans and hospitals face similar and conjoined medical record review challenges that burden the appropriate reimbursement process. We have joined together as the Advent Health Partners team to create claims review process solutions.

MEET OUR TEAM

Our Partners

Advent Health Partners’ technology solutions deliver existing integrations with several best-in-breed partners across the healthcare claims review and management process. Additionally, CAVO and Apello feature an open API that offers unlimited opportunities for successful integrations with workflow, coding, and other tools utilized by our health plan and hospital clients.

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