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AI Solution Support For SIU/FWA Programs

Increase healthcare payer program ROI with Advent Health Partners’ industry-leading AI technology.

AI Solution Support For SIU/FWA Programs

Increase healthcare payer program ROI with Advent Health Partners’ industry-leading AI technology.

SIU/FWA Prevention and Detection

Health plans invest large amounts of time and money in identifying and preventing healthcare fraud, waste, and abuse (FWA). Legacy systems and apprehension of AI solutions lead to overspending and underachievement. However, the fact remains that organizations with a robust SIU/FWA framework tend to deliver more impressive ROIs.

Advent Health Partners’ AI technology solution combats unnecessary FWA spending. Ideal for pre and post-pay FWA/SIU reviews, CAVO® instantly aggregates data, finds information within or across cases and documents, and communicates user-specific determinations.

Benefits of CAVO for FWA Reviews

CAVO’s determinations include all OCR text captured and the standardized clinical data the AI extracts from the medical record. The platform’s open API allows the team to search across cases to enhance analytics on fraud detection and includes. Its SIU function leverages CAVO’s ability to load multiple records into a single case that is searchable to determine patterns of undocumented services, upcoding, or medically unnecessary charges in less than half the time of other platforms or solutions.

Medical Record Data Mining

CAVO can search across encounters for code validation and ensure codes are accurately documented within the medical record.

Productivity Gains

CAVO has the tools and features needed to reduce medically unnecessary costs and increase productivity within your organization.

Medical Record Review technology

Automated Preparation

CAVO’s AI technology executes an initial pass of medical records for code validation and workflow prioritization.

Encoder Integration Capabilities

Integrate TruCode® & 3M within CAVO for greater transparency and productivity.

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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 support 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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