In the northeastern U.S., a large hospital discovered thousands of discrepancies between its item master, OR supply system and chargemaster. By fixing around 3,000 issues, the hospital recovered as much as $3.87 million in revenue over two years that it had previously been losing.
In the mid-Atlantic, a different hospital identified and fixed nearly 700 issues in its charge capture systems, gaining a potential four-year total of more than $4 million.
And over a single year, a 760-bed hospital recovered more than $5 million by fixing 366 charge capture issues.
Capturing charges for supplies and ensuring they’re correctly billed is a significant problem in many hospitals, and a leading cause of revenue loss at a time when hospitals are struggling financially. Typically, the cause is disparities between the purchasing, item master, OR and billing systems over issues like missing HCPCS or charge codes, mislabeled costs, incorrect links between systems, and so forth.
The three hospitals described above all used Trisus Supply to identify these disparities, make corrections and ensure they would be adequately reimbursed for all supplies used.
The Craneware Group’s Trisus Supply is an application that helps hospitals find gaps in data between their item master, OR system and charge descriptor master systems to ensure cost-to-charge accuracy. It maximizes supply chain automation and enhances compliance in patient billing, with greater claim accuracy and increased revenue integrity.
It normalizes your data and examines differences in costs across purchases, the item master and OR supply system while highlighting the charge in the chargemaster. It applies another layer of data from our Supplies Assistant database to provide HCPCS coding and description information for high-priced devices and implants.
Surveys of healthcare revenue cycle professionals suggest that coding departments spend lots of time tracking down information from clinical providers about what services, supplies or equipment they used, and that many charges are either under- or over-coded. Charge lab, coding errors, adoption adherence and compliance are also frequently cited challenges.
By normalizing your foundational data, Trisus Supply allows for more comprehensive analysis and management. It also facilitates deeper, more visible collaboration between teams, with streamlined workflows to eliminate wasteful steps that don’t add value.
With the popularity of hip and knee replacements, often done in an ambulatory setting, accurately capturing all charges becomes increasingly critical. Imagine billing for a metal-coated-plastic hip implant when you actually used titanium; the cost difference could be thousands of dollars lost.
One customer used Trisus Supply to review its pricing policy. It discovered more than 800 items that were out of compliance with its internal policy and updated 375 items in its chargemaster to accurately reflect the charge prices.
After conducting a retroactive charge volume analysis of the 375 items, the customer determined it lost $7.5 million in revenue over 20 months, all because the item prices didn’t match their pricing policy. They are now running analysis for the OR to determine if they can increase gross revenue by lowering the charge price threshold from $2,500 to $50 for supplies.
Analyses by The Craneware Group have found that the average cost of inaccuracy in supply chain management systems is $2,540 per bed of missed revenue capture per year.
Trisus Supply offers critical help ensuring revenue integrity as providers transition to value-based payments.
“Trisus Supply has improved turnaround time when reviewing claim edits with the ability to both reference charge links as well as Supply Assistant being our go-to guide for supply item inquiries,” says Teresa Calabrese, MS, CHDA, associate director, revenue cycle management at an East Coast health system.
“We leverage Trisus Supply to improve process and CDM integrity, specifically the reporting tool. Items of concern are easily identified and like items consolidated for reporting and corrections.”
Contact us today if you’d like to learn more about how Trisus Supply can help your organization improve revenue integrity.