Implant Cost Containment
Workers’ Compensation implant charges typically average more than 55% of surgical bill charges.
Devices are very expensive and have a complex supply chain where suppliers often apply enormous markups to actual purchase price.
Additionally, complex state-specific regulations make it challenging to understand what is being billed by the facility and what the correct implant reimbursement should be. Genex partners with ForeSight Surgical Implant Solutions to provide a comprehensive solution that determines appropriate implant reimbursement to provide significant savings to our customers. This program delivers objective, credible and defensible claim reductions and negotiations.
Genex’s Medical Bill Review Services and ForeSight are fully integrated to provide a seamless process and comprehensive review of all surgical implant charges.
Genex’s implant program produces more than 68% reduction in implant costs.
- Specialized bill review expertise coupled with ForeSight’s knowledge of the true cost of the implant and comprehensive implant management system
- Confirmation of the facility’s actual implant acquisition cost
- Invoice-to-claim matching
- Comprehensive applications of workers’ compensation state regulations pertinent toimplants
- Identification of disposable usage and nonimplantable supplies
- Flagging for potential fraud, waste and abuse
The Genex and ForeSight difference
- Leverage seamless integration, processing and fast turn-around times
- Reduce time spent routing claims
- Achieve maximum savings on implant bills
- Comply with state regulations