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Find More HCCs with Automated Medical Coding with Improved Accuracy
Cavo Health’s precise matching engines works differently than NLP for computer-assisted review of medical records. Instead of relying on the fuzzy word associations of machine learning, Cavo Health automates exactly for certified medical coders do. Cavo Health finds the words that confirm the presence of a Risk Adjustable ICD in a medical record. Certified coders can confirm the matches in seconds. The result? More HCCs are confirmed while chart review speeds increase 10X with greater accuracy than manual coding.
Cavo Health encrypts data in motion and at rest. Moreover, Cavo Health can run behind your firewall, making security verifications that much easier. But if you would like to use the Cloud, Cavo Health runs in a Virtual Private Network (VPN) with encrypted storage and no shared servers. Think of Cavo Health running in the Cloud as a Fort Knox inside a Fort Knox.
Cavo Health honed its processing technology in the electronic discovery industry, which is known for messy data coming in a wide variety of enterprise formats. Cavo Health’s processing is feature rich in dealing with a large assortment of data problems, from embedded images of various sizes to compressed files of compressed files seven levels deep. Cavo Health has the data processing robustness to tackle the toughest processing challenges.
Run Cavo Health in the AWS Cloud, Private Could or behind your Firewall
Cavo Health's unique architecture and Processing Plus+ technology coupled with the scalability, security, reliability, and design or our software can achieve fast results under any deployment option. Cavo Health was specifically designed to employ the most current and powerful proprietary and open source software available in a fully distributed and scalable environment.
First deployed on Amazon Web Services (AWS), the premier cloud-based computing service provider, Cavo Health can accommodate extremely large cases while delivering unequalled processing speed and exceptional performance. Cavo Health was also developed to be mounted on bare metal with the only practical limitation being the number of servers that are dedicated to the software. Its true power and speed are only limited by the resources that are provided for it to work.
Because Cavo Health has achieved linear scalability for processing, the power of many processors can be harnessed to handle large data collections with ease. The richly featured Amazon Elastic Compute Cloud (EC2) service combined with Cavo Health's innovative architecture enables users to quickly and easily scale computing resources (up or down) to meet their specific requirements through an easy-to-use Cavo Health web interface.
Cavo Health running on AWS can change the economics of electronic discovery computing by allowing you to pay only for capacity that you actually use for only as long as you actually use it. Cavo Health combines the latest distributed open source technologies like Hadoop and Mongo with an auto-scaling database to provide all the power you need for your litigation.
Scanned images are challenging enough to process. But some OCR systems are fooled by “hybrid” scanned images that contain both text and images. Not Cavo Health. Processing with Cavo Health has a setting that allows the OCR engine to both capture the text and OCR the images on the same page of a chart.
The faster you understand what information is available for you to prioritize and process, the faster you can understand the facts of the case. So starting at the first important step after gathering information, Cavo Health's Rapid Data Explosion and Preprocessing Analytics provides unprecedented speed and Early Data Analysis (EDA).
EDA provides the user with the a complete overview of the data and gain insight into the data that can be used during the Meet and Confer to set boundaries on document productions. The more you know about your data, the better you can represent your clients.
Cavo Health includes an extremely fast and efficient Data Explosion tool that unpacks Zip, PST and other container files to allow powerful pre-processing analysis, filtering and culling to occur. Our explosion rates are 650 – 800 GB /hour depending on the density of the files. An exceptional Early Data Assessment tool, Data Explosion enables the user to examine the exploded files and related metadata to determine whether information can be filtered, culled, and categorized before processing. Metadata fields can be used to determine whether expected data is available and to assign processing priorities to move the document review onto a fast track. Tasks such as:
• Determining early on that critical custodians or date ranges are missing from the collection, is something that might not otherwise be identified until after data is processed.
• Analyzing the data down to the individual email to see whether the collection is complete.
• Users can set Processing priorities by selecting key custodians, date ranges, keywords in the metadata, document type or entire corporate entities if applicable.
• Developing an early understanding of the data in the corpus.
Data Explosion with culling analytics is the single most powerful tool that can be used to reduce the total volume of data to be processed and reviewed. Your Service Provider can provide assistance in using this tool to help you work with and get an early understanding of the data corpus.
Cavo Health’s Smart Grid normalizes member data coming from the coding of medical records with claims data and data coming from other repositories. Once normalized, the Smart Grid generates custom reports that can drive member care interventions and strategic business decisions.
Cavo Health Processing Plus+
When Cavo Legal quotes you a processing speed, we are quoting a true processing speed that includes all the needed steps in one pass to process the data and prepare it for Search and Review. Our definition of Processing Plus+ is all inclusive, including a full range of capabilities and customization to fit virtually any need. Our current processing rate is over 57 GB per hour, including load time into the Cavo Health platform, ready for Search, Analysis and Review by your team.
Our true distributed processing allows us to simultaneously spread the data processing among multiple servers. When used on the AWS cloud, the number of servers selected to process is a very cost effective way to handle the short term need for lots of machine horsepower.
• Processing Plus + – We have achieved a processing speed of 57 GB per hour using raw data files from a major case. All steps are included in this speed rate: data loading, exploding PSTs and containers, customized deNist lists, deduplication, boilerplate data removal, email threading, theme capturing, OCR and documents loaded for first pass review or further analytics.
• Deployment – Can be deployed on Amazon Web Services which is highly scalable and elastic, delivering exceptional performance at reasonable rates with no upfront hardware costs, including encryption and limited access using the AWS Virtual Private Cloud. Alternatively, should you chose, Cavo Health can also be deployed behind the firewall.
• Rapid Data Explosion with Pre-Processing Analytics- Innovative pre-processing tools and data explosion allows users to perform early data assessment prior to processing, thus reducing the volume of documents to process and greatly enhance processing speed.
• Thematic Document Capture – better than keywords, our algorithms capture and rank multiple themes in each document, creating a thematic fingerprint which easily searches and classifies documents by their thematic content.
• Boilerplate – The "boilerplate template" option can be used to eliminate any language patterns that are unneeded such as standard disclaimer language that appears at the bottom of so many corporate email messages. By reducing the volume of false positive results, the search engine and users can then focus on truly relevant document content that may impact the case.
• DeNist – Customizable lists to reduce unneeded data files from being processed.
• DeDuplication – multiple Duplication identification options are included to provide fully customized options based on the needs of the litigation. Duplicates can be displayed during the review or hidden, based on need.
• OCR – Full OCR for all documents without text.
• Embedded Objects – Customize the maximum number and sizes of Embedded Objects to include in the searchable data, and whether to display them inline or as separate documents.
• Hidden Data – System can display hidden data (e.g., white text, document changes, etc.) after Processing.
• Culling Settings – Data can be culled by Type, Custodian, Size and Folder for exclusion or processing priority.
Cavo Health uses over one-half million queries to find around 10,000 ICDs that map to HCCs. Each query is sufficient to confirm an ICD. As a result, with an average of 50 ways to find an ICD that confirms an HCC, Cavo Health often finds HCCs that were missed using other methods. In fact, we at Cavo Health are so confident that Cavo Health will find HCCs missed by other methods, we are willing to serve clients with a revenue-share of new HCCs found by Cavo Health during a First or Second Pass Review.
Cavo Health makes it quick and easy to confirm ICDs in medical records. Once Cavo Health has identified the ICDs in a medical record, it presents them to medical coders along with their surrounding text. Cavo Health also provides the Section where the ICD is found, the Encounter ID, date and provider, and any medicines that provide additional MEAT. The coder has everything they need to quickly confirm the presence of the HCC in the medical record. As a result, medical coders can review medical records much faster while improving their accuracy and thoroughness.
Patient records contain enormous amounts of key information that is now buried outside of the structured data that exists in the EMRs defined fields. As a result, data in unstructured notes (such as imbedded EMR notes typed or dictated by providers) is lost to assimilation and analysis for identifying health care trends, outcomes, costs, and connections between various providers and patients. In addition, these EMRs are from different companies and are often incompatible with each other and with external systems. Cavo Health cuts across systems to reach into medical records and extracts key data based on broad search parameters. It then presents this critical information in an intuitive visual format.
With no human intervention, Cavo Health auto-codes medicals records with the accuracy and thoroughness. And Cavo Health scales linearly. As a result, Cavo Health can auto-code millions of medical records with amazing speed.
With this fast coding throughput, Cavo Health can audit the medical claims of providers and payers against the corresponding medical records in near real time.
Studies show that around one-third of the codes of medical records are inaccurate. This means that payers who reimburse against unaudited claims data can assume that possibly one-third of their payments are insufficiently justified. Payers accept this reality because there has been no practical alternative.
Until now. Cavo Health can auto-code medical records overnight, so that payers can immediately know whether a bill is justified by the member’s medical record. With Cavo Health’s coding accuracy, this method can help correct billing problems early in the process, speed up reconciliations, and reduce the risk of submitting incorrect data to CMS. Cavo Health provides two-way coding at its best.
Health care systems today manage the outcomes of huge numbers of patients. Health care entities such as insurance companies and ASCs can use Cavo Health to quickly and accurately assess their covered lives for risks, trends, and key cost drivers. By using better data, better decisions can be made to both improve patient care and lower costs.
Most big data Medicaid investigations rely on recognizing anomalies in billing patterns. This method has achieved success, but is limited to those unscrupulous providers who are careless in their Medicaid billing.
So, in addition to this approach, Cavo Health provides an entirely new way of revealing Medicaid waste, fraud, and abuse with big data analysis. Cavo Health can identify whether the billing data is supported by the Medicaid recipients’ medical records.
Here’s how Cavo Health does it: With no human intervention, Cavo Health auto-codes medicals records with accuracy and thoroughness. And Cavo Health scales linearly with additional hardware. As a result, Cavo Health can auto-code millions of medical records with amazing speed, and compare these codes to the codes billed to Medicaid.
Cavo Health is therefore a powerful new tool for auditing Medicaid claims in large scale. Combined with the electronic discovery toolkit of Cavo eD, Cavo Health offers a new, comprehensive approach to combating Medicaid fraud.
But Cavo Health ability to help improve the effectiveness of Medicaid programs does not end there. Cavo Health can also help reduce waste and abuse. By coding the medical records of recipients, Cavo Health can reveal which recipients are receiving medicines and treatments that they shouldn’t, which recipients are not receiving the medicines and treatments that they should, and when billed amounts for treatments and prescriptions do not match the doctor’s orders.
Cutting edge research depends on accurate information. In addition, patient enrollment in clinical studies depends on identifying patients in a given provider’s population that meet both in inclusion and exclusion criteria for the study. Cavo Health easily analyses large data sets to provide better information. Baseline data is quickly identified. Subtle trends are easily discovered. Both structured and unstructured data is easily analyzed.