A National Multi-line Managed Care Payer that serves as a central intermediary for both government-sponsored and privately insured health care programs saved $2M+ in 10 Minutes by leveraging our CAVO® end-to-end platform.
The organization was tasked with auditing one of their larger itemized bills (IBs) they needed to overcome: a $10,000,000+ claim that consists of over 300 pages. As with many companies, IB reviews were a time-intensive process due to the variety of formats and overall document length.
We introduced our CAVO® IB Review solution to the employees responsible for preparing and reviewing the itemized bill. They loaded the 36,000+ line-item document and then processed the claim through CAVO® IB Predict, which normalizes the entire IB regardless of format, and makes recommendations on line items likely to be adjusted based on CMS codes, industry standards, and organization-specific policies.
Leveraging machine learning and intelligent software, our full spectrum solution provides immediate predictions to decrease work time, as well as increase the accuracy and consistency of results. CAVO® IB Predict revealed $2,000,000+ in charges that could be removed before any intensive review began, and the RNs finished validating the results in less than 10 minutes.