CAVO® Itemized Bill Reviews intakes itemized bills and auto-extracts data so health plan reviewers can:
Sort and filter itemized bill data
by revenue codes, dates of service, and item descriptions
Make line adjustments
for accept/reject by line using organization-specific reason codes
Utilize real-time totals
with auto-summed adjustments and charges
Create provider reports
with auto-generated headers

Client Snapshot
Regional Health Plan, Prepayment IB Reviews

THEN
Payment integrity nurse reviewers requested itemized bills directly from the provider or exported from the hospital EMR – and received both as PDFs. They then reviewed the charges line-by-line and manually keyed denial reason and reported rejections to the provider.

NOW
Payment integrity nurse reviewers replaced the manual line-by-line review process with a targeted approach based on filterable, sortable itemized bill data. They are leveraging CAVO’s open API to import the captured IB data directly into the plan’s internal workflow—ensuring IB reviews are completed within a single platform.

What Our Clients Are Saying
“As a member of the beta group for the CAVO IB Reviews initiative, I was impressed with how well the technology translated our itemized bills into usable, sortable data. I found that the technology cut my average itemized bill review time by two-thirds. As a CAVO user of more than a year, I’ve experienced the platform evolving, and I’m excited about the possibilities as CAVO IB Reviews is also continually enhanced to improve efficiencies throughout the review process.”
Claims Analyst, IB Reviews Partner

BENEFITS OF USING CAVO IB REVIEWS

Less Cost
- Cost savings on incremental reviews
- Reallocate data entry resources to higher value activities

More Reviews
- Increase productivity of current provider bill review team
- Dramatic decline in time per review enables increase (or implementation) of pre-pay reviews

Create Efficiencies
- Negate the need for itemized bill transcription
- Replace manual page-by-page review with online hospital bill search


Postpayment Review
Perform postpayment reviews with CAVO + CAVO IB Reviews
- Search for related medical record information within single platform