Our Approach
Since 2009, Our Implant Audit Services have focused on pre-payment, re-pricing and validating charges for implantable devices. We provide a multifaceted audit approach that combines implant industry experts experienced in selling to hospitals and surgeons.
Implant Audit Services
- Forensic review of implantable devices
- Implant specific information
- Cost detail by manufacturer
- Defensible results
- FDA review
- Detailed reporting for every aspect of implantable devices
Implant Formulary Development
Clarity Implant Solutions will assist clients in the development of adequate and predictable implantable device reimbursement for providers. We customize and develop an implant formulary price based on your current provider usage by manufacturer. Bundles are the newest contracting option utilized to reduce overall spend on implants and prevent provider hospitals from maximizing profits.
We use paid claims data, our knowledge base and up to date implant data, to develop customized implant case pricing. Pricing is calculated for each type of procedure by identifying implants typically used in that procedure, their average cost by manufacturer and recommended reimbursement by type of hospital. Each pricing module is delivered in 45 days or less.
Provider Cost To Charge Analysis
We have been reviewing healthcare and worker’s compensation claims for the past decade. As Payers modify reimbursement practices, Hospitals react to maximize profits.
We review historical data on paid claims to supply a Provider Cost to Charge Analysis of Implants. We identify the implants used and at what price, and compare that with the average for those implants by that manufacturer. Our analysis can also give real-time comparisons of products from different manufacturers. Our analysis is essential when negotiating or renewing contracts with providers.