The Cavo Suite

Cavo Health offers an end to end suite of risk adjustment coding products for improving coding accuracy and completeness and automating workflows.



Faster, More Accurate, and More HCC Completeness with Precise Word Matching AI and Full Workflow Customization



Onshore and Offshore Professional
Coding Services


Direct Access to EMRs for Faster, Less Costly Chart Retrieval, Prospective Programs and 100% Workflow Automation



RADV-Ready your Claims While Improving Payment Integrity



EMR Auto-Coder allows doctors to see more patients, spend more time with them and get paid faster.

Ask Us About Our Full Cavo Suite

Cavo Health excels as a First Pass Review coding tool giving coders unmatched speed and accuracy over traditional methods for health plans, medical practice groups and coding vendors.



Faster, More Accurate and More HCC Completeness with Precise Word Matching AI and Full Workflow Customization



Onshore and Offshore Professional Coding Services



Direct Access to EMRs for Faster, Less Costly Chart Retrieval, Prospective Programs and 100% Workflow Automation



RADV-Ready your Claims While Improving Payment Integrity



EMR Auto-Coder allows doctors to see more patients, spend more time with them and get paid faster.

Cavo Coder

Cavo Icon ACavo Coder is Cavo Health’s premier product supporting faster, more accurate, and more complete risk adjustment coding.

A main problem that health plans have is that they are not finding all the HCCs they could. Cavo Coder solves that, especially when Cavo Coder is used in combination with the full suite of Cavo Health products.

Here are some highlights of Cavo Coder:

1)  Find More HCCS on the First Pass. In fact, Cavo Coder finds 96%+ of the HCCs before coders start coding. And Cavo Coder is equally successful as a Second Pass or even Third Pass tool to insure the most accurate and HCC complete review of medical records. Check out the Case Study of Cavo Coder. In that study, Cavo Coder helped a health plan’s First Pass coders confirm charts with over 98% accuracy and completeness.

 2)  Increase Coding Speed 2x to 4xwith auto-detection of:

  • Dates of Service
  • Supporting Medicines
  • Support Words
  • Sections
  • The most specific, best supported codes
  • Reduce RADV Risk of unsupported claims while accurately capturing RAF Scores

Only Precise Word Matching AI can accurately find all the information that is required to confirm diagnoses to CMS risk adjustment standards. Cavo Coder delivers all this information to coders which saves them time and makes them faster without a loss of accuracy or completeness.

3) Reduce RADV Risk of unsupported claims while accurately capturing RAF Scores. Because Cavo Coder is powered by Precise Word Matching AI, Cavo Coder can provide a “two-way” review of claims. Cavo Coder can filter on the claims that are supported in the medical record and the claims that are not supported in the medical record. Moreover, Cavo Coder can filter on the ICDs and HCCs that were not in the claims but which are supported by the medical record. So, with Cavo Coder, you can easily verify your claims with unmatched speed while also improving the accuracy and HCC completeness of your coding. Your CFO and your head of compliance can shake hands on Cavo Coder!

4)  No Machine Learning Means Fast Set-up, No Model Training, and No Model Drift. Cavo Health’s Precise Word Matching AI finds the diagnoses in medical records and their supporting documentation without any training required. That’s because Precise Word Matching AI is not based on machine learning. Instead, Precise Word Matching AI uses millions of “queries”, that is, collections of words that confirm the presence of a diagnosis with exact precision for the most specific code. If one of the “queries” match the words in the medical record, you can know with certainty that Cavo Coder has found a potentially confirmable code. No machine learning required. No model drift. And processing of medical records is fast. With Cavo Coder, you know your charts will be ready for coding as soon as you need them.

Here are some of the key differences of Cavo Coder versus other risk adjustment coding tools:

  • Precise Word Matching Technology and Automated Workflow
  • Auto-Coding of Charts for First Pass Review and Second Pass or Third Pass QC
  • 4M+ queries, progressive accuracy improvement
  • 96% HCC Accuracy First Pass Review with minimum 2X+ increase coding productivity
  • Codes to highest specificity, Combo codes and Primary/Secondary codes, HCC mappings for Medicare, Medicaid and ACA/Commercial
  • ICD-10 Guidance with additional coding instructions i.e. “Code first” and “Code also”. Cavo shows the “Includes” and “Excludes” notes found in the ICD 10 book
  • Improve Submitted Code Accuracy & Compliance, Reduce RADV risk


Cavo Coder provides Coders with the information to make correct coding decisions FAST. Here are some of the highlights of how Cavo Coder does that:

  • Image highlights Precise Matching of ICDs & HCCs
  • Always finds the most specific code for the documented disease
  • Ranks codes for the strength of the documentation supporting them
  • Display “Sections” ICD found — Assessment & Plan, Discharge, Hx of Present Illness, Health Maintenance
  • Shows Combination codes, Chronic and Acute codes, and Medicines supporting ICD
  • Finds the Electronic Signature for fast verification
  • HCC Mapping based on Dates of Service – updated for CMS’s changing lists of ICDs and shows the correct ICD for the DOS
  • Coding Rules Customized by Client
  • Searchable Image of EMR


Cavo Coder Automates Coder Management and Reports. Here are several ways Cavo Coder automates Coder Management and provides the data you need to maximize the efficiency of your coding team:

  • Automated Workflow and Set-up
  • Dashboard reports by Review Set
  • Progress Reports – daily tracking of productivity & completion ETA
  • Automated QC workflow with sampling
  • RAPS, EDPS Reports
  • Real-time system integration to other databases via API, or to a web application via I Frame, as requested by client
  • 18 Standard Reports plus Custom Reporting

Cavo Coding Services

Cavo Icon 2Often, coding managers need to supplement their coding teams with onshore and/or offshore coders. Cavo Health can help. We have premier coding teams available to meet your coding needs.

The difference between Cavo’s Coding Teams and other coding resources is that we are highly selective on whom we hire. Before we will consider adding a coder to our teams, coders need to be certified and have years of experience coding risk adjustment. If the coder has the proper credentials, they are interviewed. If they pass the interview, the coder must pass Cavo’s difficult coding test. Most coders who apply to be on our teams cannot pass the test. The select group of superstar coders who do pass must then go through extensive training using the Cavo Coder tool. These coders are rigorously evaluated for their proficiency in using all the capabilities that Cavo Coder offers for the most accurate and complete coding. Not all of them make it.

Just like in the military where only the “best of the best” can make it on special forces, the same is true for risk adjustment coders who want to be on the Cavo Coding Teams. It takes special coders. When you hire Cavo Coders, you know you are getting the best coding available because the best coders are using the best tool powered by the best NLP.

Cavo Access Platform

Cavo Icon 3Comparing Cavo’s Access Platform to traditional chart retrieval services is like comparing today’s modern automobiles with the horse & buggy of yesteryear.

Cavo Access Platform’s technology connects right into the EHR systems that hold your charts. The Access Platform is smart enough to get you the complete charts you need for risk adjustment coding with no extra documents that you don’t need or want. And the Cavo Access Platform gets you the complete charts fast, within days, not weeks or months after you’ve ask for them.

But that’s not all. Like the high-tech automobile versus a horse and buggy, the Cavo Access Platform gives you many more benefits versus traditional methods. For example, the cost of retrieving charts is much lower. Additionally, the charts can be automatically processed by Cavo Coder’s Precise Word Matching AI. They will be ready to start a First Pass review with over 96% of the HCCs highlighted within hours after retrieval.

And this is just the beginning of Cavo Access Platform’s many automations. For instance, you can run the Cavo Prospective Programs with end-to-end automation using the Cavo Access Platform. You can use the Cavo Missed Code Monitor to find the codes with evidence but incomplete documentation. Or use the Cavo Suspecter Tool to find the codes that are implied by the documentation. Or use Cavo Dropped Codes’ solution to look back historically and find the coding errors made in the past. You can even use Cavo Predictor to find your members who likely have undiagnosed HCCs and need to see a provider right away for treatment.

Or use all four products in the Cavo Prospective Program and maximize the accuracy of your risk adjustment coding efforts. What’s more, you can enhance each of the Cavo Prospective Program products with additional clinical data pulled from EHRs. Please contact us to discuss the possibilities.

Of course, you might be thinking about all the provider coordination challenges of such a robust Prospective Program. The Cavo Access Platform can help here, too. With the permission of the provider organizations that own the EHRs with your charts, Cavo Access Platform can automatically notify physicians with documentation training, alerts of possible member HCCs, and even schedule appointments for your members to see physicians.

Yes, the future is finally here. But only if you are using the Cavo Access Platform to automate your risk adjustment coding efforts end to end.

Cavo Claims Integrity

Cavo Icon 4It would be nice if all it took for risk adjustment reimbursement was to submit the HCCs found in claims. But, unfortunately, neither the Centers for Medicare and Medicaid Services (CMS), nor the Office of Inspector General (OIG), nor, especially, the Department of Justice (DOJ) see it that way. If the claims are not supported by the medical record, then submitting them for risk adjustment reimbursement could result in an unfavorable RADV audit with penalties, or worse. No plan wants to be defending themselves against an OIG or DOJ lawsuit.

The best way to protect against negative outcomes is to confirm your claims in the medical record using Cavo Claim’s Integrity’s new technology before submission.  You will find claims validation a breeze with the automated two-way look of Cavo’s unique Precise Word Matching AI. And with a free consultation, we will help you design an overall claims integrity solution that matches your specific compliance needs while possibly saving you money.

Importantly, CMS has made it a priority for risk-bearing entities to help them cut down on Fraud, Waste, and Abuse (FWA).   By using Cavo Claims Integrity, CMS will appreciate that you are taking the extra step to make sure their Medicare, Affordable Care Act, and Medicaid dollars are not being wasted on inaccurate claims.

But best of all, you can sleep at night knowing you are taking the compliance high road. This is something your RADV auditors will appreciate, as will any government investigators who happen your way.

Cavo EMR Auto-Coder

Cavo Icon 4

Doctors went to med school to diagnose patients, not to code medical records. Yet modern EMR systems require doctors to “point and click” to navigate complicated coding decision trees. This extra work slows physicians and often delays payment of medical bills. Cavo EMR Auto-Coder simplifies and solves these problems, so doctors can see more patients, spend more time with them and get paid faster.


EMR Auto-Coder immediately receives physicians’ notes after each encounter through integration with your system.


EMR Auto-Coder automatically codes a physician’s note within seconds using Cavo Health’s unique Precise Word Matching AI engine.


Using Cavo Coder, a professional reviewer completes chart coding within one to five minutes. The reviewer confirms codes, identifies suspects and recommends documentation improvements.


The EMR Auto- Coder sends the confirmed codes and documentation comments to the physician for review in their EMR portals.


EMR Auto-Coder can tap into
its proprietary Disease Prediction AI to determine medical conditions that are likely to develop in the near future. This information can also be sent to the physician’s portal at the same time.



Within minutes after entering notes and often before the patient checkout, physicians update the patient’s note and treatment plan and lock the chart for billing.


Cavo Prospective Program

The Cavo Prospective Program is robust. With four different products, the Cavo Prospective Program assists doctors with accurate documentation four important ways. And when you also use the Cavo Access Platform, your entire Prospective Program can be automated – no more back and forth with physicians needed!

Here are the Cavo Prospective Program’s Four Products

Cavo Suspecter

Finding Suspects is vital to a strong risk adjustment effort as well as good care of a health plan’s members. As well trained as physicians are, they still can occasionally use assistance in covering all the bases in identifying risk adjustable diseases even when the evidence for these diseases is implicitly documented in the charts. Cavo Suspecter can find this implicit evidence and report back Suspect codes for physicians’ review. Because it relies on the unprecedented accuracy of the Cavo Precise Word Matching AI engine, Cavo Suspecter delivers greater Suspect completeness with fewer False Positives.

Cavo Missed Code Monitor

Clinicians are generally not professional medical coders. That’s why physicians sometimes document strong evidence for risk adjustable diseases but fail to properly document them with MEAT. Cavo Missed Code Monitor automatically identifies and measures the strength of the documentation of diseases. For instance, Cavo Missed Code Monitor will tell you whether a disease is supported by a medicine, the “active voice” of the treating physician, a strong section of the encounter, or located in an Acceptable Document.

Cavo Predictor

The sooner you can get treatment for your sick members, the better off they will be. That’s why Cavo Predictor is so important. Cavo Predictor uses AI to automatically predict which of your members are more likely than not to be diagnosed with either diabetes or heart disease in their next visit with their doctor. Cavo Predictor will also identify those members who are more likely than their peers to have other serious diseases, like cancer, Alzheimer’s, and morbid obesity, diagnosed on their next encounter. And when using the Cavo Access Platform, you can automatically schedule a physician appointment for your members, assuming your provider organization allows this.

Cavo Dropped Codes

Professional risk adjustment coders are skilled at what they do. But even the best coders miss diagnoses that could have been confirmed for risk adjustment reimbursement. No so with the Cavo Precise Word Matching AI engine. This new technology which powers all Cavo Health products will find at least 96% of all the HCCs that are present in a chart. The Cavo AI engine simply identifies virtually every risk adjustable code. That’s why combing previously coded charts with Cavo Dropped Codes is so useful in finding historical coding errors.

See Why Our Precise Word Matching AI™
Is So Accurate And Fast!

Watch the video below to see what this innovative technology brings that manual coding or machine-learned NLP cannot.