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GPOs – Valued Partners in Healthcare
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The healthcare group purchasing organization (GPO) members of HSCA work closely with their provider partners across the continuum of care to reduce cost, add value, and improve outcomes for patients. Below you'll find some narratives that help to demonstrate why GPOs are valued partners in healthcare.

 

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Optimize|Item Master Identifies $500,000 in Billing for Omaha Children’s

Posted By HSCA, Friday, January 15, 2016

The challenges faced by health care providers throughout the United States are daunting. Reimbursements are declining while costs are increasing, and staff is feeling pressure to do more with less. Simply getting paid for the services that are provided is an undertaking that can easily consume a vast amount of resources. In fact, billing and collections can be the most challenging factor in the revenue cycle equation. Health care providers are constantly adjusting their billing and collections methods in an effort to accommodate changing regulations and keep up with industry standards.

This is certainly true at Children’s Hospital & Medical Center in Omaha, Neb. — the only full-service pediatric specialty health care center in Nebraska. At Children’s, no child in need of medical care is ever turned away because of inability to pay. This may be why, according to Chris Klaiber, materials manager at Children’s, “we’ve always been paid a high percentage of the charges we bill.”

This was the case until fall 2012, that is. Chris and his team began noticing that some insurance payers were requiring that Healthcare Common Procedure Coding System codes be included when billing for certain items. “We’d never had a situation that required us to include HCPCS codes, so this was new to us,” said Lori Kirsch, value analysis nurse at Children’s. “Even if there was only one line item that was missing a HCPCS code, the payer would refuse to pay the entire bill.”

Realizing that these interruptions in their revenue cycle were unsustainable, Children’s began urgently looking for the missing codes to move the revenue process forward. Using every resource they knew of to tackle the problem, resources were stretched thin as their “all hands on deck” approach turned registered nurses into makeshift medical billing coders.

“Vizient helped Children’s bill over $500,000 within a couple of passes through Optimize|Item Master. Just imagine trying to fill a $1 million hole in your budget, and finding over half of it in one place. That’s huge.”  Read the rest of the story here.

Tags:  Cost  Nebraska  Vizient 

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