The surgical suite is getting hit with the double whammy of rising device costs and reduced procedure reimbursements. Case-in-point, the Center for Medicare and Medicaid Services’ (CMS) rates for hip and knee reimbursements dropped from $1,600 to $1,350 in 2014. It’s become even more critical to maximize revenue on high-dollar surgical supplies, like orthopedic implants.
The unfortunate reality is: it’s all-too-common for coding errors to occur at the hand of manual recording and tracking methods, meaning supplies can be submitted for reimbursement at only a fraction of their total revenue potential. That’s where technology can be your ally. It’s now possible to maximize supply revenue potential with a simple scan of a mobile device. Once an implant is selected, a case nurse or manufacturer rep can use mobile technology to properly identify and code the exact implant used. In place of an excess of duplicative paperwork, surgical staff can simply scan the implant bar code to create a requisition line (bill-only or re-order), assign the HCPCS, and appropriately assign the charge code. Here’s how your surgical suite will benefit:
- System Integration: To ensure your organization is being properly reimbursed for supply usage, there needs to be a streamlined process and support all the way from the surgical team to the supply chain and revenue cycle staff. Technology can improve the process of sending information from one department to the other. The case nurse or rep is able to immediately scan the device code into the case file directly from the operating room. When items are accurately scanned and logged into the appropriate case, the revenue cycle team is able to initiate proper reimbursements to ensure no money is left on the table.
- Streamlined Inventory: Today, multiple implant sizes are ordered and stocked for cases. Challenging the status quo are bill-only purchase models, where the purchase order (PO) can be generated during the case once a surgeon selects the right implant for the patient. This allows health systems to only pay for implants used, eliminating paying for inventory that may sit for weeks or months. Implementing a so-called “bill-only” policy for orthopedic implants can reap long-term benefits, both in terms of time and cost-savings.
- Spend Visibility: Guaranteeing the products purchased during a surgical procedure are on contract is important to supporting a healthy supply chain. With mobile technologies, case nurses and manufacturer reps can verify on the spot if an implant is on contract. This helps drive utilization compliance. Additionally, the surgical team is responsible for approving the bill-only requisition, creating an avenue for improved financial accountability.
- Simplified Shopping: Initializing your procurement system to enable bill-only POs allows reps or case nurses to instantaneously update your purchasing system. Once a used item is scanned, the mobile technology triggers the creation of a shopping cart for the case nurse who is responsible for re-ordering supplies. Instead of writing out a written request that would sit on someone’s desk for processing, technology can speed up the process of making sure you have the items you need for the next case. Reps accessing the mobile technology are only privy to their company products and do not have access to sensitive or confidential information about pricing agreements with other suppliers.
With technologies available today, make sure you’re not losing out on revenue due to human error. Implementing a bill-only purchase model supported by mobile technology can help improve the bottom line in your surgical suite, saving time and streamlining coordination between the surgical suite, revenue cycle and supply chain. It’s a win-win-win.
