Billing Oversight Approval Process

Challenge

A large hospital chain spent many hours each month trying to resolve billing conflicts with distributors across multiple locations.

Distributors would issue their billings each month and the facility material managers would use equipment ledgers to examine whether they were correct or not. Invoices were approved at the facility level. With much of the communication for orders and pickup requests occurring over the phone, information often went undocumented. A common miscommunication that then occurred was when a distributor would charge the equipment pick up date as the patient off date. Many times the two dates weren’t the same which would translate into extra billable days. Unresolved disputes between material managers and distributor reps were long and tedious, with distributors often waiting months to get paid. Frequently, billings were just approved and sent to corporate for payment without close examination.

Resolution

SentinelC3 developed a web-based billing system giving the healthcare organization and distributor provider open book visibility, at a granular level, into the products and devices being used at each facility. The system details each line item, with use by day, week, or month, so the controllers/managers/vendor reps can now accurately match up products with billings at each facility. An approval process was put into place where nothing was paid until it was approved by both the facility and vendor and then triple checked by Sentinel’s Support team. Sentinel’s Support team members are assigned specific care facilities and their corresponding vendor partners to establish close relationships with each, fostering better communication and documented understanding.

With the SC3 centralized billing system, the material manager can either approve an invoice or ask for an adjustment to a line item. The distributor can either approve the adjustment or cancel it, at which point the support agent facilitates communication and provides a documented history of the line item if necessary. Only after complete agreement by both the facility and the distributor is the adjustment created and finalized in the billing.

Results

Before using SentinelC3, the hospital chain had been paying almost 20% more than they should have due to errors on invoices. The vendors themselves, after being alerted to past errors, have worked to improve invoicing. However, errors still occur, and with the SC3 billing and reporting systems in place, final invoices now are typically 12% less than the original invoices submitted.

By utilizing an automated review and dispute process, the billing/payment process was uniquely effective and payments to distributors were handled quickly. Conflicts have been greatly reduced and are now handled in a timely manner. The hospital was able to reduce in house accounting hours by reducing the number of checks they had to process each month, and by no longer having to deal with prolonged billing disputes.