Healthcare Business challenge

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Presentation transcript:

Healthcare Business challenge Rapid changes in healthcare regulations and laborious claims processing have led to inefficiency in the US healthcare revenue cycle, with billions of dollars tied up in insurance claims denials.1 Transformation Using IBM Cloudant to underpin its CAVO tool, Advent decreases time taken to review claims by up to 500 percent, accelerating healthcare revenue cycles and helping hospitals to recoup millions of dollars. “Recently, a hospital used CAVO to overturn a million‑dollar claim that the insurer was refusing to pay.” —Bill Butler, Vice President, Software Architecture, Advent Health Partners Business benefits: Up to 500% faster claims review Millions of dollars returned to hospitals for services provided Improves efficiency of analysts so they can review more claims annually Advent Health Partners Revolutionizing healthcare claim denials with up to 500 percent productivity lifts Solution components IBM® Cloudant® Client Name Advent Health Partners Company Background Part of the Powered Health group, Advent Health Partners (Advent) drives maximum financial returns for healthcare providers. It uses its CAVO technology to provide claims appeal services, coding corrections of denied claims—both as an outsourced service offering and as a standalone product. Business challenge Rapid changes in healthcare regulations and laborious claims processing have led to inefficiency in the US healthcare revenue cycle, with billions of dollars tied up in insurance claims denials. The benefit CAVO improves the efficiency of the claims appeal process by up to 500 percent, helping providers recoup millions of dollars from erroneously denied claims for services provided. Pull Quote “Recently, a hospital used CAVO to overturn a million-dollar claim that the insurer was refusing to pay.” Bill Butler, Vice President, Software Architecture, Advent Health Partners Solution components IBM® Cloudant® Case study Link http://www.ibm.com/common/ssi/cgi-bin/ssialias?subtype=AB&infotype=PM&htmlfid=CDC12348USEN&attachment=CDC12348USEN.PDF Footnotes 1. American Hospital Association: Uncompensated Hospital Care Cost Fact Sheet (http://:www.aha.org/content/12/11-uncompensated-care-fact-sheet.pdf) Part of the Powered Health group, Advent Health Partners (Advent) drives maximum financial returns for healthcare providers. It uses its CAVO technology to provide claims appeal services, coding corrections of denied claims—both as an outsourced service offering and as a standalone product. Share this