What is Bill Only? Challenges and Considerations

“Bill Only” refers to medical implants that are not recorded in hospital inventory and billed to the hospital after a procedure is complete. In a Bill Only case, the required implants and hardware are not carried in the hospital’s inventory and are delivered for the case the day of the case or the day before the case is set to begin.

 

“Bill Only purchase order” (PO) refers to the procurement document generated at the end of the Bill Only process whereby bill only items are paid for by the hospital’s supply chain department.

Here’s a typical workflow that illustrates the challenges healthcare providers face when handling Bill Only cases:

 

The Bill Only process begins when a supplier delivers loaned inventory to the hospital ahead of the scheduled procedure. This inventory often includes high-cost, specialized devices or implants, and it’s the vendor rep’s responsibility to document what is used. The device rep manually records the utilized inventory and pricing on a paper charge sheet—typically a sticker sheet—and submits it to the operating room (OR) team.

 

Once the procedure is complete, the OR team must validate the items listed on the charge sheet against what was charted in the electronic health record (EHR). This manual reconciliation process introduces the potential for discrepancies, such as mismatches between what was used in the procedure and what was documented. These inconsistencies can result in delayed or incorrect billing.

 

Following the validation, hospital staff manually enter the data into their enterprise resource planning (ERP) system to create a requisition for the used items. The pricing is then cross-checked against the hospital’s item master or contract repository to ensure that the correct contractual terms are applied. Any discrepancies between the documented usage and the agreed-upon pricing need to be resolved before the requisition can move forward.

 

Once the pricing and item details are confirmed, the hospital generates a Bill Only purchase order (PO) and sends it to the supplier. At this stage, communication back and forth between the hospital and supplier is often necessary to clarify any discrepancies related to products or pricing. This back-and-forth can create delays in the billing and payment process, making it more cumbersome for all parties involved.

 

This traditional process, reliant on manual documentation, verification, and communication, often leads to delays, errors, and significant administrative burden for hospitals. It also increases the likelihood of missed charges or discrepancies, which can negatively impact both the hospital’s finances and the supplier’s relationship with the organization.

Bill Only is necessary for hospitals and vendors because medical implants are not one-size-fits-all.

Medical devices like implants are not subject to the traditional procurement-to-payment process that most hospital inventory is subject to, where items are selected and paid for through the ERP system. This is because every patient is different – even slight changes in patient anatomy can require the use of a different implant. This simple fact makes it impossible for implants to follow the standard procurement procedure.

 

Bill Only is very important in the business of surgery because it is a significant source of wasteful and erroneous spending. This is a result of the traditional lack of visibility into the bill only process, where the accuracy of the line items on a purchase order is often questionable. Exactly how many of each delivered item were used in a case? The surgeon and OR nurses might have a good guess but rarely an exact amount – and the difference between those two figures can spell disastrous consequences for both operating room and hospital profitability.

The most impactful way to improve the Bill Only process is to digitally transform it using modern technology. The traditional Bill Only process is broken – a manual process fraught with errors that takes significant time away from patient care. Operating room nurses didn’t go to school to do paperwork. It’s time for the healthcare industry to evolve the way it approaches this necessary process.

 

ReadySet’s Bill Only process is designed to simplify and streamline the billing process for healthcare providers. By automating and standardizing various aspects of the billing cycle, we help ensure accuracy, efficiency, and compliance.

The process begins as soon as a case is scheduled. A bill sheet is automatically tied to the case, ensuring compliance and preventing duplicate Bill Only purchase orders (POs). Before the case begins, users are alerted of any off-contract requests. This allows you to add these requests to the item master or reject them.

Once the case is complete, the charge sheets are standardized and digitized. These can be submitted through various methods, including direct integration with vendors via ReadySet, automatic generation from charted patient records, or paper files uploaded through the ReadySet application. To ensure accuracy, we validate case use against utilization data, reconciling it with the implant log.

ReadySet also verifies the accuracy of prices and contract status by referencing the item master and contracts repository. This helps prevent errors and ensures that billing is in compliance with all relevant agreements.

Our centralized approval process involves key stakeholders to ensure timely decisions and approvals. Once approved POs can be automatically generated through your ERP system. Automated alerts are then sent to vendors, providing them with access to all necessary documentation in the ReadySet portal.

ReadySet’s built-in analytics allow you to monitor vendor performance and manage relationships effectively. By tracking key metrics and identifying areas for improvement, you can optimize your billing processes and ensure that vendors are meeting your expectations.

Schedule a free 30-minute demo to learn more about the ReadySet Bill-Only solution and how it can benefit your facility.