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Streamlining the Claims Review Process

Health Plans

Common Health Plan Payment Integrity Challenges

In the Claims Review Process

SYSTEMS

Utilization of multiple systems with varied interfaces typically impede productivity during health plan claim reviews

DOCUMENTATION

Retrieving clinical documentation for medical record reviews and itemized bill reviews is time-intensive and often produces PDFs requiring manual review

PEOPLE

Nursing shortages and widely varying average medical record review and itemized bill review times create staffing challenges

TIME

Timely filing requirements and consistently decreasing health plan payment integrity review thresholds require more productivity

Our Health Plan Payment Integrity Solutions

CAVO

SOLVES FOR:   SYSTEMS  Ι  PEOPLE  Ι  TIME

Increase audit productivity 300+% by instantly searching medical records

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CAVO for Itemized Bill Reviews

SOLVES FOR:   SYSTEMS  Ι  PEOPLE  Ι  TIME

Extract, review, and adjust itemized bill (IB) charges line-by-line

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CAVO Connect

SOLVES FOR:   DOCUMENTATION

Directly access EMRs via validated Cerner and Epic apps

CAVO Connect delivers health plan EMR access
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CAVO Predict

SOLVES FOR:   PEOPLE  Ι  TIME

Prioritize reviews with suggested data points

Begin payment integrity review automation initiatives with CAVO Predict
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Schedule healthcare claims review technology demo

1:1 LIVE DEMO

See our 20 minute payment integrity solutions overview!

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