Revenue Enhancement

Understanding of how supply expense is related to reimbursement can uncover additional opportunities for your facility to consider.  Some of the areas that we review include:


  • Do you have the correct HCPCS codes loaded for items?  Mapping to the wrong codes will lower reimbursement.
  • Understanding how reimbursement maps to supply costs with Orthopedic Implants is a must, it provides better negotiation strategies and allows you to better understand profitability.  Recent studies show that your Orthopedic Implants should be in the 30% to 35% range related to reimbursement.
  • Where you receive reimbursement for outpatient charges such as clinical lab tests should be equal to or higher than the Medicare rate, if not, you will receive the lower of your charge.