Blue Cross Blue Shield received about $25 billion in medical claims for adult beneficiaries undergoing elective orthopedic procedures in 2017, according to a 2019 review cited by Tara Vail, chief operating officer at ASC software company HST Pathways.
With knee and hip replacement volumes on the rise, ASCs can take steps to lower these costs, Ms. Vail said in an article on AJMC Managed Markets Network.
Five strategies:
1. Collect patient history, insurance information and consent forms online before the patient arrives at the ASC.
2. Monitor costs for supplies such as surgical tubing, needles, sutures, suction tips, retractors and laparoscopic instruments to weed out unnecessary expenses.
3. Make sure physician documentation clearly states which implants were used and that accurate data is entered at the time of charge entry.
4. Consider utilizing predictive analytics to forecast implant needs and reduce overnight shipping costs.
5. Use up-to-date revenue cycle management tools to compare physicians' implant costs and spot discrepancies between expected and received payments from insurers.