Apello end-users are able to quickly surface relevant information needed from medical records and external documentation using advanced search capabilities and pre-defined, high-frequency queries. After locating the needed text, image, or page, Apello users select, highlight, annotate, and/or assemble individual pages to easily create a detailed appeal packet - including an optional summary using Apello’s library of letter templates. Users can also efficiently share the packet directly from Apello via email, fax, download, or an API.
- Appeal a claim: When a claim is denied due to medical necessity, an analyst, nurse, and/or physician pulls in the documentation directly via Smart on FHIR and searches (optionally using one of Apello’s pre-defined smart searches, if applicable) to immediately find decision data. The user then annotates, crafts, and sends a compelling appeal to the denying entity based on the patient’s progression and interventions. This process is completed in a fraction of the time previously needed.
- Validate a DRG: Apello is designed to vastly reduce the time to determine the appropriateness of the billed DRG pre- and/or post-pay. Coders, nurses, and physicians search for documents supporting the diagnosis sequencing if the DRG assigned is consistent with the documentation and treatment during the hospitalization.
- Request Authorization or Release of Information: Apello provides a channel for efficient storage and exchange of documentation for analysts, nurses, and physicians throughout a patient’s stay and billing cycle. Specifically, before a service is rendered, the authorization can be saved as a document in Apello; after the service is rendered and billed, supporting documentation can be delivered directly to the health plan. If the patient remains in the hospital and requires an additional authorization, the provider can easily submit medical records (or plans with CAVO® users may directly obtain them).
Compatible with Cerner Powerchart
Medical Record Smart Logic Searches & Pre-Defined Searches
Use the Apello smart search functionality to instantaneously receive relevance-ranked results. Pre-defined searches provide complex searches for common terms, such as anemia.
Highlights & Notes
Pinpoint decision information with Apello’s highlight tool, and type relevant comments and tie to a specific highlight with the Notes tool.
Easily create an appeal packet containing only individual pages from the Review tab.
Add a summary page customized from an organizational template with Apello’s Letter Editor function.
Integration with TrueCode Encoder Essentials
Utilize the TruCode Encoder Essentials integration to easily assign and validate appropriate codes from within Apello.