What is Bill-Only?
Understanding Bill-Only in the Healthcare Industry
Regarding medical devices like implants, one size does not fit all. Patients require implants specifically suited for them, making hospitals unable to stock patient-specific implants as they do with other inventories. Because of this, procuring and paying for patient-specific implants is complicated. This process is often referred to as “Bill-Only.”
But, what exactly is “Bill-Only” and why is it important?
“Bill-Only” refers to the invoicing process and products specifically procured for a patient by a vendor sales representative during or near a medical procedure. It is not possible for a hospital to pre-order patient-specific items and stock them in inventory like other non-patient-specific supplies. Instead, the hospital “only” pays for the items used post-surgery, resulting in the term “Bill-Only.” The process of Bill-Only involves purchasing and paying for these products after their use.
Why is Bill-Only important?
Today, 32 million Americans, or roughly 10%, have an implantable device, with the market projected to grow from approximately $90 Billion to ~$169 Billion by 2030. Patient-specific implants can also represent up to ⅓ of a hospital’s supply expenses. As the demand for patient-specific implants grows, controls around hospitals’ Bill-Only processes need to be examined. And unlike stock supplies, hospitals typically have little visibility, oversight, or data into the Bill-Only process.
What are the challenges of Bill-Only?
Selecting the correct implant for a patient requires careful consideration by the surgeon based on their clinical judgment, training, and experience. Patient-specific implants are typically used in orthopedic, cardiovascular, and neurosurgical procedures. Because of this, patient-specific items require a significant degree of customization and, therefore, cannot be stocked in the regular hospital inventory with other items, such as syringes and surgical gloves.
Surgeons often prefer specific brands or models of implants based on factors such as clinical outcomes, implant longevity, and ease of use. As a result, the use of surgeon-driven implants is often controversial in healthcare, as it can lead to higher costs and variation in clinical outcomes depending on the surgeon’s preferences. However, some argue that allowing surgeons to choose the implants they believe are most appropriate for a specific patient can lead to better clinical outcomes and patient satisfaction.
Ideally, hospitals should work with surgeons and supply chain teams to balance accommodating surgeon preferences and ensuring quality patient care while considering cost, standardization, and patient safety. However, procuring implants is solely left to the vendor and surgeon, leaving the hospital and supply chain with little oversight of the implants purchased.
In addition, auditing and processing Bill-Only purchasing requests is time-consuming, error-prone, and needs more controls. Since vendor bills are received after the surgery, the bill and purchase orders must be reconciled against the hospital’s EMR, ERP, item master, and contracts. Managing the process is complex and manual for most hospitals, with multiple people and departments verifying contracts for pricing and implant supply logs against sticker sheets and paper bills.
The absence of oversight in the Bill-Only process results in errors and millions of dollars of undermanaged hospital products, reduced visibility to expenses, and employee waste. In addition, without a single source of truth, it’s challenging, if not impossible, for supply chain leaders to access the data needed to manage the Bill-Only process.
Across multiple baseline assessments, Casechek has found, on average, $8.5M in potential savings and errors from items undocumented in the EMR, unnecessary vendor fees, and excessive ordering of reusable accessory items. In fact, on average, each hospital had 9% of spending undocumented in the EMR or roughly $6.5M of undocumented items.
Streamline your Bill-Only processes with Casechek
Casechek built the industry’s only Bill-Only automation with 5-Way Bill Match to address these issues and create true automation. 5-Way Bill match automatically reconciles and validates bills against the EHR, Item Master, Contract, Vendor Bill, and GUDID to create a No Touch PO. By validating vendor bills against the implant log in the EHR, you have automatic insights and visibility into documentation issues. 5-way Bill match helps you reduce cycle times and overpayments and improve expense cycle management. While also improving UDI compliance and patient safety. Casechek’s Payment solution is the only solution to improve EMR Accuracy to >99%.
Your hospital may use different terms
Your health system likely has the same problem but may use a different name. The healthcare industry does not have a standardized term to refer to patient-specific implants, causing them to be referred to under a variety of names, such as:
- Bill-Only Items
- Physician Preference Items (PPI)
- Physician-selected items
- Surgeon-preferred products
- Physician-preferred devices
- Clinician-choice items
- Patient-Specific PPI
- Patient-Specific Implants
- Same Day Items
- Provider preference products
- Doctor-directed supplies
- Surgeon-driven implants
- Clinician-chosen materials
- Medical professional selected items
- Practitioner-selected products
“Physician Preference Items (PPIs)” is used quite frequently to refer to patient-specific implants. However, PPI is broader, referring to any medical devices, supplies, and equipment that physicians or surgeons prefer to use during procedures based on their experience, training, and familiarity. In contrast, “Bill-Only” refers to items specific to a patient for a procedure and the process to pay for them.
What term does your hospital use? Please take a brief survey to let us know.
Glossary of Common Terms:
- Bill-Only Items: refers to the invoicing process and products specifically procured for a patient by a vendor sales representative during or near a medical procedure. It is not possible for a hospital to pre-order patient-specific items and stock them in inventory like other non-patient-specific supplies. Instead, the hospital “only” pays for the items used post-surgery, resulting in the term “Bill-Only.” The process of Bill-Only involves purchasing and paying for these products after their use.
- Physician Preference Items (PPI): refer to medical devices, supplies, and equipment that physicians or surgeons prefer to use during procedures based on their experience, training, and familiarity.
- Physician-selected items: refer to items or products chosen by a physician for a specific patient based on their medical condition, treatment plan, or individual needs. This could include medications, therapies, or other medical interventions the physician deems most appropriate for the patient’s situation.
- Surgeon-preferred products: also known as surgeon-preference items, are medical devices, instruments, or supplies that surgeons prefer to use during surgical procedures based on their experience, training, and familiarity. Surgeons may have individual preferences for specific brands, models, or surgical tools and equipment designs that they believe provide better outcomes for their patients or make the procedure more efficient.
- Physician-preferred devices: also known as physician-preference devices, are medical devices or implants that physicians prefer to use in their clinical practice based on their personal judgment and experience. Physicians often select these devices due to perceived clinical benefits, familiarity, ease of use, patient outcomes, or other considerations specific to their medical specialty.
- Clinician-choice items: refers to medical products, devices, or treatments that clinicians, including physicians and other healthcare providers, choose based on their clinical judgment and expertise. These items are selected by clinicians based on factors such as their knowledge, experience, patient needs, and the available evidence. Clinician-choice items can encompass various healthcare interventions, including medications, therapies, medical devices, surgical techniques, diagnostic tests, and more.
- Patient-Specific PPI refers to medical devices and supplies specific to the patient and the physician’s or surgeon’s preference per procedure based on their experience, training, and familiarity.
- Patient-Specific Implants (PSIs): also known as custom implants or personalized implants, are medical devices designed and manufactured specifically for individual patients based on their unique anatomical characteristics. PSIs are typically used in orthopedic surgeries, where the shape and size of an implant need to be tailored to the patient’s specific needs.
- Same Day Items: generally refers to medical supplies, devices, or medications obtained and used on the same day as prescribed or requested. These items are typically needed for immediate or urgent.
- Provider preference product: refer to medical devices, supplies, or equipment that healthcare providers, such as physicians, surgeons, or clinicians, prefer to use based on their personal preference or experience. These products are selected by providers based on factors such as perceived clinical benefits, familiarity, ease of use, patient outcomes, or other considerations specific to their medical specialty.
- Doctor-directed supplies: may refer to medical supplies or equipment prescribed, recommended, or directed by a doctor for specific patient care or treatment purposes.
- Surgeon-driven implants: are medical implants selected or chosen by surgeons based on their personal preferences and expertise. These implants are typically used in surgical procedures and are selected by the surgeon based on their experience, familiarity, clinical outcomes, and patient-specific requirements.
- Clinician-chosen materials: refer to the selection of specific materials, substances, or products by clinicians for use in patient care based on their clinical judgment and expertise. Clinicians, including physicians, nurses, and other healthcare providers, may choose certain materials for various purposes, such as wound dressings, sutures, medical devices, or implantable materials.
- Medical professional-selected items: refer to medical supplies, devices, equipment, or materials chosen or selected by healthcare professionals based on their expertise, clinical judgment, and experience. Medical professionals specifically choose these items to meet the needs of their patients and provide the best possible care.
- Practitioner-selected products: refer to medical supplies, devices, equipment, or materials chosen or selected by healthcare practitioners based on their professional judgment, expertise, and experience. Practitioners choose these products to meet the specific needs of their patients and provide the best possible care. Practitioner-selected products can encompass various items, including medications, diagnostic tools, therapeutic devices, wound care supplies, and more.