From the May 2017 issue of HealthCare Business News magazine
Michael DeLuca

With reimbursement rates dropping, hospitals are doing everything they can to maximize the revenue potential on every case.

One common area of revenue loss is inaccurate coding that leads to lower reimbursement of high-dollar surgical supply usage. Changing the status quo could be as simple as using mobile technology to replace current manual methods.



Current reality
When a surgeon selects an implant for a total joint replacement, for example, the case nurse or manufacturer rep manually documents the item used as part of the case record. The paperwork is then sent to the purchasing and revenue cycle departments for reimbursement processing. The manual process increases the likelihood of error and improper assignment of HCPCS codes, potentially resulting in a lower reimbursement rate.

Eliminate manual entries
When health systems eliminate manual entry, they can save time and reduce the risk of inaccuracies. Mobile technologies can allow the case nurse or vendor rep to scan the product barcode directly from the operating room, pre-populating the lot and serial number and assigning the proper charge code for the item. Catching errors and verifying charge codes through manual intervention isn’t perfect and is incredibly time-consuming for the revenue cycle team. When manual entries are eliminated, it increases revenue cycle efficiencies and ensures no money is left on the table, in terms of reimbursement.

Improve the requisition process
Accurately tracking supply usage is not only critical to maximizing reimbursement, but also for proper inventory management. When supplies are used during surgery, the same technologies that are used to scan and assign accurate charge codes can be used to reorder supplies or authorize an invoice for the supply used in the case of a consigned inventory program. With one scan, case nurses can quickly and accurately document the items used and add them to a shopping cart in the health system marketplace so they are promptly submitted for requisition. This helps ensure the right items are available for the next case.

Enhance contract compliance
Guaranteeing the products purchased during a procedure are on contract is key to a healthy supply chain. Mobile technologies allow case nurses and manufacturer reps to verify on the spot if an item is on contract, reducing the chance that a vendor rep will sell a non-contracted supply at a higher price margin. Any device selected for use that is off contract requires staff to enter it manually. In addition, it can help ensure that the purchase order matches the invoice, eliminating match exceptions. Scanning the item used directly from the surgical suite reduces the burden of having to search through an item master, which can often be missing important pieces of information such as product images, specialized part numbers and preferred status tags which can lead to selecting the improper device.

May 2017 Magazine

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