The Problem

Lack of insight into expected reimbursement models on a per patient basis created scenarios where third-party medical device reps would utilize devices in surgical procedures that we're not in compliance with hospital contracts. As a result, Device costs for surgical procedures sometimes exceeded the total reimbursement for the procedure, especially in instances where reimbursement was fixed fee (Medicare/Medicaid).

The Solution

Documentation Capture and Enhancement

  • Scheduling Interface
  • Patient/Insurance Demographics
  • Scrubsheet/Implant Log Creation and Monitoring

Process Automation

  • Procedure Flagging/Alerting
  • Procedure Status Assignment
  • Scrubsheet Estimate 
  • Notification and Auto Escalation
  • Contractual Compliance (Implant Items)
  • PO Assignment

Business Intelligence

  • Dashboards and Trending
  • Expected Reimbursement Analysis
  • Utilization - By Procedure, Surgeon, Manufacturer, Etc.
  • Financial Reporting