Health Plan Clinical Payment Integrity Technology Platform
Reduce administrative and claim costs and increase payment accuracy through industry-leading technology.
Decrease Administrative Cost and Claim Expense
Health Plans can lower claim expenses and administrative costs by increasing reimbursement accuracy through Advent Health Partners’ purpose-built, AI-driven technology platform. CAVO® enables the identification and validation of clinical billing errors quickly and accurately through a proactive, clinical data-driven approach. Implementing payment integrity technology decreases your internal team’s time and costs while simultaneously increasing claim savings opportunities.
Advent’s AI technology ingests, normalizes, and classifies relevant data sources and extracts the critical data attributes required to make a final reimbursement determination from medical records and other unstructured data sources. This creates a lower-cost, higher-value clinical review and audit program that reduces provider abrasion and appeals and lowers the cost of healthcare to your clients, employers, and members.
$250MM
saved in claim expenses since CAVO’s inception
350%
average user productivity increase within 90 days of implementation
100MM+
insured members supported across commercial, medicare advantage, and managed Medicaid markets
32%
average reduction in administrative expenses
Implementing Payment Integrity Technology
Strategy
CAVO enables payers the capabilities to support various strategic initiatives such as moving from post to a pre-pay environment, shifting between vendor and internal reviews with ease and flexibility, or increasing the volume of reviews to maximize claim savings without adding high-cost resources.
Efficiency
Our technology streamlines the review process by extracting the appropriate data and presenting it efficiently “in-platform” to your team, enabling quick, data-driven decisions and lowering costs.
Consistency
CAVO adapts to the unique needs of your organization, ensuring the quality and accuracy of each and every review.
Transparency
Advent’s AI technology removes conventional friction between internal and external resources by providing transparency and depth in the review process.
CAVO Use Cases
Why Use Advent's Health Plan Payment Integrity Solution?
Reduce Review Time and Cost
CAVO’s AI-driven sort, filter, annotate, highlight, and notation functionalities reduce the time your team spends reviewing claims.
Get Claims Paid Accurately and Quickly
We streamline your process and extract appropriate data to ensure claims are paid accurately and in record time.
Investing in the Health Plan-Provider Relationship
Health plans and health systems have always been closely intertwined. Even though plans and providers share the common purpose of reducing healthcare costs for patients and members, sometimes there can be dissonance. Investing in the health plan-provider relationship and focusing on similar shared goals sets up both parties for a mutually beneficial relationship.
How does an improved connection with providers positively impact health plans? This eBook outlines nine benefits our health plan partners discovered through Advent Health Partners’ enhanced provider connections.
Topics include:
- Facilitation of Prepay Review
- Accurate and Timely Claim Payment
- Reduced Dependency on 'Pay and Chase' Methodology
- And more...
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About CAVO
CAVO® is a revolutionary technology platform that supports various complex clinical claims review processes performed by health plans and services companies. CAVO empowers highly skilled clinical and coding resources with AI-driven functionality that shifts the focus from “low value” tasks and requirements such as document access, search, analysis, and determination support within medical records and other unstructured data to “high value” tasks and requirements such as validation and final determination. The technology enables clinical and coding reviewers to easily access and structure medical records, itemized bills, and additional clinical data efficiently, consistently, cost-effectively, and profitably.
With over one million completed case reviews, CAVO delivers technology proven to scale up your medical record reviews and increase your team’s productivity by 300%-500%.
Get in touch to discover how Advent Health Partners can help your organization tackle its business challenges.
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