Tools For Fast, More Complete Risk Adjustment Coding

We find more than 96% of your HCCs before coding even starts

Cavo Coder

Cavo 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. 

   2)  Increase Coding Speed 2x to 4x with auto-detection.

   3) Reduce RADV Risk of unsupported claims while accurately capturing RAF Scores. 

   4)  No Machine Learning Means Fast Set-up, No Model Training, and No Model Drift. 

 

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. 

  • 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. 

  • 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

Often, 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

Comparing 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.

By The Numbers

Cavo Health leads the market in NLP-driven, Computer Assisted Coding in accuracy, completeness and speed

96

+
%

ICDs found in charts before coders even start

98

+
%

Accuracy and completeness on first pass coding

4x

Faster coding speeds with auto detection capabilities

6M+

Queries with progressive accuracy improvement

Cavo Integrity Uses Unique Precise Word Matching AI to Find Over 96% of Specific ICDs in Medical Records

Extreme Sports Bike

For payment integrity, the first real question is whether the claim is diagnostically supported by the medical record. Cavo Integrity’s unique Precise Word Matching AI will answer that question in milliseconds.

Cavo Integrity’s Precise Word Matching AI uses millions of “queries”, that is, collections of words that confirm the presence of a specific ICD, to thoroughly search every page of the medical record for specific ICDs. If this technology cannot find diagnostic evidence for a claim, you can be virtually certain that the claim is in error.

If the claim has diagnostic support, the next question is whether the procedure or treatment was medically necessary according to CMS standards. Cavo Integrity will tell you that also – in milliseconds.

What Our Clients Say

“Since partnering with Cavo, we have found their solution to be easy-to-use and fast with a high level of accuracy. Cavo Health is a great business partner!”

VP RISK ADJUSTMENT OPERATIONS
FALLON HEALTH

“Cavo Health’s Precise Word Matching NLP tool for risk adjustment combined with their innovative team has made our partnership a great success.”

VP CLINICAL AND QUALITY OPERATIONS
EQUALITY HEALTH