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.
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.
Simplify steps for staff
Finding a solution that simplifies steps for staff involved is critical. In order to ensure your hospital system is being properly reimbursed for supply usage, there needs to be a streamlined process and support all the way from the surgical teams to the supply chain and revenue cycle staff. That means that the information in the surgical room should be easily sent from one department to the other. Rather than shuffling paperwork around and risking that it might sit on a desk for days to weeks, with a simple scan of an item, surgical staff can feel confident that the information is properly submitted for the revenue department to take action.
Shift responsibility to the vendor rep
In addition to improving efficiencies with the revenue cycle, it can also simplify the steps between a vendor rep and a case nurse. In cases with a supplier rep, it streamlines the process by shifting ownership away from the case nurse to the rep. Reps will only get paid once a requisition is entered. The process of scanning an item in the surgical suite makes it more efficient and easier for reps to use than manual entries. Reps can be provided access to filtered information in the purchasing system limited to their company products and not sensitive or confidential information about pricing agreements with other suppliers. This helps a rep alert the case nurse of items used so that the case nurse can easily submit a requisition without having to reenter information.
Implement new tracking technology at your facility
Operating at status quo is sometimes easier than making a change. However, adding a scanning functionality is as simple as downloading an app and does not require special hardware. Taking the time to implement new technologies for tracking and coding supply usage can provide your hospital benefits, both in terms of time and cost savings. Baptist Health South Florida, the largest health care organization in the region, with seven hospitals and over 30 outpatient and diagnostic centers, had a tremendous amount of resources tied up in the reimbursement process. The supply chain team searched for a solution to streamline the process. In 2015, the health system implemented a technology solution to help accurately track and code supply usage in the surgical suite.
Natalie Pita-Ortiz, assistant vice president of supply chain services at Baptist Health, shares her advice on how to successfully implement technology to maximize revenue on supplies.
• Support suppliers: Fear of rep pushback was an initial concern. However, Baptist Health found reps were very open to using new technology after learning the benefits and how simple it was to integrate. Showing the reps that they can enter the requisition immediately, resulting in a quicker payment schedule, was important.
• Integrate gradually: Start with a handful of suppliers and build champions of the program. Baptist Health implemented the technology solution system-wide, beginning with the orthopedic and joint suppliers (among the highest dollar supplies) before moving on to cardiac rhythm management. They brought two to three suppliers on board each month. By slowly transitioning suppliers, it gave both parties time to adjust and troubleshoot. Once they had successfully transitioned a supplier, they used the success stories from the implementation process to share with any rep who was hesitant about the transition.
While revenue loss due to inaccurate coding plagues most health systems, it does not need to be your reality. Integrating new supply chain technologies can help streamline the process of tracking and coding supply usage so you don’t miss out on any revenue.
About the author: Michael DeLuca is executive vice president of technology and client services for Prodigo Solutions, a health care supply chain solutions company helping hospitals gain control of supply chain spend through contract compliance and automation.