The Markets We Serve

Markets We Serve

Health Plans

Health plans need a risk adjustment solution that helps them code medical records with greater accuracy and HCC completeness — and do this while coding faster and easier with less work for staff and less cost. Cavo Health’s suite of products accomplishes that and more.

Cavo Coder software, powered by Precise Word Matching AI, finds over 96% of the HCCs in charts before coders even start. Using Cavo Coder, coders review charts faster, more accurately, and with more HCC completeness. Moreover, Cavo Coder’s multi-function user interface makes Cavo Coder an ideal tool for efficient coder management in First Pass, Second Pass and even Third Pass reviews.

If your plan needs additional coding support, Cavo Coding can provide outstanding Offshore and Onshore coding services. Cavo Access Platform connects directly to EMRs to provide faster and less costly chart retrieval and a host of automated services supporting Prospective Programs and communication with your providers. And Cavo Payment Integrity will “RADV-ready” your claims while identifying the claims that should not be paid because they are not supported by the medical record.

For health plans involved in government programs, the Cavo Suite has you covered. Your CFO, Coding Lead and head of Compliance will all shake hands on Cavo’s risk adjustment coding products.

Please contact us for a demonstration and a free needs assessment and consultation on your unique needs.

Medical Practice Groups

For medical practice groups taking on risk, it is essential for their financial performance and risk management that they use the best risk adjustment coding tools available. That’s why medical practice groups should start using the Cavo Health Suite. Let us explain.

Cavo Coder Software, powered by Precise Word Matching AI, finds over 96% of the HCCs in charts before coders even start. Using Cavo Coder, coders review charts faster, more accurately and with more HCC completeness. Moreover, Cavo Coder’s multi-function user interface makes Cavo Coder an ideal tool for efficient coder management in First Pass, Second Pass and even Third Pass reviews.

If your medical group needs additional coding support, Cavo Coding provides outstanding Offshore and Onshore risk adjustment coding services.

Beyond more accurate and HCC complete coding, Cavo Health also offers special advantages for medical practice groups. For instance, the Cavo Access Platform integrates with your EHR and Cavo Coder to automate the retrieval and processing of your medical records for coding. And with your

permission, the Cavo Access Platform can automate communication with your physicians with scheduling patient appointments and notifying physicians of their patients’ potential diseases and improved documentation methods.

With four distinct products, Cavo Health’s Prospective Program offers multiple benefits for medical practice groups. Cavo Predictor will predict when a patient is likely to be diagnosed with a particular chronic disease on their next visit. Cavo Suspecter identifies clinical data that indicate suspect diseases. Cavo Missed Code Monitor finds those HCCs that were under documented for CMS submission. Cavo Dropped Codes finds those chronic HCCs that were documented in the past but are no longer present in current documentation.

And, of course, every medical practice group wants to be paid on time and reduce revenue cycle challenges. That’s where the Cavo Payment Integrity solution will help. Using the amazing accuracy of Cavo Health’s Precise Word Matching engine, Cavo Payment Integrity will immediately identify claims that are not supported by the medical record so they can be corrected before submission to payers. This will also “RADV-ready” your claims for stellar compliance success.

Please contact us for a demonstration and free needs assessment about how Cavo Health’s suite can help your unique medical practice needs.

Coding Vendors

Vendors that provide risk adjustment coding services to risk-bearing entities can offer their customers higher coding accuracy and HCC completeness when using Cavo Coder Software powered by the only Precise Word Matching AI engine in the world. Your customers will be thrilled with the results. And you will be thrilled with the many ways Cavo Coder can help you reduce your coding team costs with a multitude of coder management tools.

To begin with, coding teams using Cavo Coder, typically increase their coding speeds 2x to 4x. That’s because Cavo’s Precise Word Matching engine finds all the required MEAT criteria a coder needs to confirm codes. Coders tell us that using Cavo Coder Software is like “being given the answers to the test.”

Plus, Cavo Coder provides virtually unlimited workflow flexibility. No matter whether you are hired to perform a First Pass, Second Pass or Third Pass review, or even a custom compliance project, Cavo Coder can be set up to automate the job.

For example, in one minute, you can configure Cavo Coder for Medicare Advantage, ACA Commercial or Managed Medicaid projects just by loading the ICD mapping for the task. It’s that simple. No models to train because Cavo Coder does not use machine learning. Cavo’s Precise Word Matching engine requires no model training. It’s ready to go when you are!

And you will surprise and delight your customers with Cavo Health’s full suite of products. The Cavo Access Platform connects directly to EMRs to provide faster and less costly chart retrieval and a host of automated services supporting Prospective Programs and communication with providers.

Plus, there is no better way to validate claims for risk adjustment than Cavo Payment Integrity. Powered by Cavo’s amazingly accurate Precise Word Matching AI engine, Cavo Payment Integrity will identify all the required MEAT criteria for claims and simultaneously identify the claims that probably should not be paid because they are not supported by the medical record.

Please contact us so we can discuss how Cavo Health’s suite of products can help you better serve your unique customers. We look forward to providing you with a demonstration and a free consultation.

Disease Prediction

The sooner sick people can receive treatment, the better off
they will be. That’s why Cavo Predictor is so important. Cavo
Predictor uses AI to automatically predict which patients have
an elevated likelihood of being diagnosed with a serious
chronic disease in their next visit with their doctor.

Cavo Predictor will identify those patients more likely than their
peers to be diagnosed for the first time with heart disease, diabetes, COPD, and morbid obesity, among other serious
diseases.

When using the Cavo Access Platform, Cavo Predictor can
automatically schedule a physician appointment for people at
risk, assuming the physician’s provider organization allows this.

Likewise, with the Cavo Access Platform, Cavo Predictor can
automatically send a message to physicians about the undiagnosed diseases their patients may have.

Please contact us so we can discuss how Cavo Predictor can
help your organization and the patients in your care.

Payment Integrity

Payment Integrity is crucial to the financial performance of health plans. CMS studies show that over
8% of the Medicare claims it receives are ‘improper”. Payment Integrity experts see similar claim
error rates for private health plans and risk bearing
provider organizations. Unfortunately, even the
best Payment Integrity systems let improper claims
slip through because they do not check the basic
question of whether the claim is supported by the
medical record. Cavo Payment Integrity solves this.
Cavo Payment Integrity uses Precise Word Matching
AI™ to automatically review medical records with
high accuracy. This Precise Word Matching AI engine

finds virtually every serious disease with its most specific ICD and measures the support for the disease in the medical record. If the Precise Word Matching AI engine cannot find diagnostic support for the claim in the medical records, odds are very high that the claim was submitted in error.

Whether you manage the payment of claims at a health plan, or are a medical practice taking on risk, or are a vendor providing Payment Integrity services, the Cavo Payment Integrity Solution will significantly improve your current Payment Integrity Program and strengthen overall financial performance.

Please contact us so we can explore how Cavo
Payment Integrity can assist your efforts and unique
process for reducing payments of inaccurate claims.

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.