Privacy Policy Slider ImageADV_HP_LS_orange-line_03

CAVO DRG Audits

Using Technology to

Transform

DRG Validations

Healthcare industry statistics indicate payers often get it wrong in DRG reimbursement, inappropriately downgrading DRGs for sepsis, acute respiratory failure, acute kidney failure, blood loss anemia, and pneumonia.

Now: Manual DRG reviews

Payment integrity coders and/or nurses determine appropriate DRG for reimbursement by sifting through mountains of paper sent by the provider.

Plans have varied processes for verifying – and confirming – the diagnosis billed aligns with treatment during hospital confinement.

Next: Search-assisted reviews

Coders and/or nurses use technology to pinpoint needed information and make decisions 300+% faster – prepay or postpay. 

  • Prepay reviews: Improved TATs leveraging a pre-defined search library for even quicker decisions and postpay audit avoidance
  • Postpay reviews: Trend which savings are realized immediately or extrapolated in future savings

KEY FUNCTIONALITY FOR DRG VALIDATION

Predefined Searches

  • Library of 100s of available complex “and”, “or”, and “not” statements designed to efficiently pinpoint DRG validation information
  • Customizable to incorporate payer policies

Audit Common DRGs Faster with CAVO

READ HOW

Acute Encephalopathy

Severity and treatment plan determined by cause

Pneumonia

Multiple treatment plans based on origin and type

Sepsis

Many different criteria used to code

Schedule healthcare claims review technology demo

2 MINUTE VIDEO DEMO

Watch a faster DRG audit

CHECK OUT CAVO

Webinar Replay

Related Articles

CAVO Client Success

CAVO Case Studies