Payer Solutions

CAVO: DRG/IB Reviews

CAVO® is enterprise technology that streamlines the medical record review process by providing specific business process solutions to your organizational challenges in one multi-faceted platform.

AI-Driven Medical Record Review Technology To Help Your Payer Organization

The CAVO® technology platform streamlines the medical record review process at both the functional and enterprise level. Using deep clinical and coding expertise in conjunction with NLP and ML as the backbone of our AI-driven use case deployment, CAVO facilitates a 10X faster claim or record review, significantly improves the financial outcome per FTE, and accelerates ongoing process improvement. Learn more about our payer solutions below.

saved in claim expenses since CAVO’s inception

%

average user productivity increase within 90 days of implementation

insured members supported across commercial, medicare advantage, and managed Medicaid markets

%

average reduction in administrative expenses

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%.

Use Cases

IB Reviews

DRG Reviews

Medical Necessity

Provider Appeals Management

Built-In EMR API Access

Simplify the clinical documentation and record retrieval process for claims reviews with CAVO® Connect. With provider support, CAVO Connect enables health plan EMR access using FHIR to real-time data in medical records, itemized bills, and additional clinical documentation—while eliminating both provider and your plan’s costly administrative burden.

MORE ABOUT CAVO CONNECT

“Not only can reviewers easily pull up a patient’s entire file on the computer screen, now with a few keystrokes they can search a 10,000-page medical record and see all references to specific data points within seconds…[our] ultimate goal in switching to CAVO’s technology is to migrate all of our records into CAVO.”

– Manager, Payment Integrity

Why Use CAVO?

Reduce Review Time & Cost

CAVO’s AI-driven sort, filter, annotate, highlight, and notation functionalities reduce the time your team spends reviewing claims.

Get Claims Paid Accurately and Quickly

We streamline your process and extract appropriate data to ensure claims are paid accurately and in record time.

Strategic Partnerships

TREND can accommodate specific times, days, or review types to eliminate gaps in nurse reviewer coverage.

Learn More

Implementing CAVO

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Strategy

CAVO enables payers the capabilities to support various strategic initiatives such as moving from post to a pre-pay environment, shifting between vendor and internal reviews with ease and flexibility, or increasing the volume of reviews to maximize claim savings without adding high-cost resources.
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Efficiency

Our technology streamlines the review process by extracting the appropriate data and presenting it efficiently “in-platform” to your team, enabling quick, data-driven decisions and lowering costs.
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Consistency

CAVO adapts to the unique needs of your organization, ensuring the quality and accuracy of each and every review.
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Transparency

TREND’s AI technology removes conventional friction between internal and external resources by providing transparency and depth in the review process.

Supercharge Your Data With CAVO's AI

CAVO Classify

Unstructured, complex data is quickly converted to a consistent and usable format through the use of AI to determine its unique source.

CAVO Extract

Critical components of usable and intelligently sorted data are quickly extracted and displayed to support particular business process use cases.

CAVO Predict

NLP and AI act as force multipliers for auditors, allowing them to focus their attention where needed instead of searching complex medical documents.
How CAVO Works

Our Certifications & Integrations