Notes for owners · Industry-Specific Software Guides
Where an Orthopaedic Hospital Loses Money on Implants and Packages
Most leaks sit where implants, packages and insurers meet: consignment implants not matched to vendor bills, items outside the package left off, and pre-authorisations that stall. GullySystem builds implant, package and follow-up records for orthopaedic hospitals. A small fracture clinic without implant surgery may not need this.
Ganesh HS, Strategy and Technology, GullySystem · · 3 min read
Consignment implants and vendor invoices
Plates, screws, nails and joint components often arrive on consignment. The vendor’s representative brings a set to the OT, and the stickers from used implants go into the case file.
The leak opens when the vendor’s invoice comes later. It may list a different size, an extra screw or an item that was opened but not used. If the OT record is a handwritten sheet, accounts cannot check it.
Record each implant from its sticker at the time of surgery. Brand, size, lot and serial number belong against the patient.
- Implant sticker details per patient
- Consignment stock kept apart from owned stock
- Vendor delivery notes matched to OT use
- Unbilled and returned items listed monthly
Package bills that go out short
Joint replacements and arthroscopies are often billed as packages. The package sets what is included. Anything outside it has to be added by hand.
An extra night, a second implant, a costlier brand or added physiotherapy are the usual misses. They are noted on a ward chart or an OT sheet and never reach the bill.
Check a sample of last month’s package bills against the case files. The pattern shows quickly.
Pre-authorisation that stalls a surgery date
Insured patients need TPA pre-authorisation before planned surgery. The TPA asks for X-ray reports, the implant quotation and the doctor’s notes. Files wait on a desk while the OT slot sits unused.
Keep the pre-authorisation status against each planned case. List the documents asked for and what has been sent.
Then look at claims after discharge. Queries that sit unanswered delay the money.
- Pre-authorisation status per planned case
- Documents asked for and sent
- Claims raised, queried and settled
- Queries waiting on the hospital
Reviews and physiotherapy that never happen
After discharge come suture removal, check X-rays and physiotherapy sessions. Patients who miss them are rarely called. Each missed review is a visit not billed and a patient less looked after.
Set review dates at discharge, not on the next visit. Give the desk a daily list of patients who were due and did not come.
What to check first
Start with implants, because the amounts per case are high. Take last month’s surgeries and match the stickers in each file to the vendor invoices. Any mismatch is a leak or a record gap.
Next, compare package bills with the ward and OT charts. Then count reviews due against reviews done.
Each check needs one owner. Write their names down.
Orthopaedic leak check sheet
A sheet with one row per surgery from last month. Columns hold implants from the stickers, implants on the vendor invoice, items outside the package and whether they were billed, and the first review date kept or missed. Gaps show where to start.
Open a blank worksheet to printQuestions owners ask
Will software match vendor invoices automatically?
Not on its own. It holds implant use from the OT and the vendor’s delivery notes side by side. Someone in stores or accounts still reviews and settles each mismatch.
Can images stay in our current X-ray viewer?
Yes. Reports can sit on the patient record, while images stay in your viewer or PACS. A link is set up where that system allows it.
Does this help a small fracture clinic?
Less so. A clinic that plasters and refers out has few implants and packages. Review reminders and a simple record may be enough.