Advanced Medical Strategies Reveals Prices for Millions of Implants
Advanced Medical Strategies (AMS), an industry leader in delivering technology-driven solutions for payment integrity, risk management, and high dollar claims issues, is proud to announce a major expansion to ImplantDx – the only online, fully transparent implant cost directory in the industry. The number of unique implants and devices now amount to well over 2 million. In addition, the number of searchable implant categories has increased from hundreds to thousands.
Nic Andre, AMS Product Development Manager: “At our symposium last year AMS presented its 2017 roadmap entitled ‘Bigger. Better. Faster. More.’ With the new data and pricing for literally millions of implants and devices, I think the ‘More’ portion has been suitably realized. While quite an achievement, this isn’t the endpoint by any means. It’s merely another progression along the continuing evolution of the Predict Suite.”
It is no secret that medical-surgical implants and devices remain a cost transparency black hole in the health and casualty industries. Payers have long relied on AMS to provide this information, but ImplantDx is much more than a simple medical device price transparency tool. Payers can now leverage detailed clinical and financial metrics on the 2.4 million items in order to:
- Mine and benchmark provider charges for implants with powerful pricing information, allowing for reference based pricing reimbursement, invoice plus pricing reimbursement, UCR audits, and direct negotiations
- Enable true cost-plus provider network contracting and repricing administration of implantable devices without the need for provider-supplied invoices, ensuring provider contract adherence and payment integrity
- Identify potential savings and minimize excessive reimbursements on out-of-network medical device and implant charges by using AMS’ on-demand analytics
- Compare charges for implants and devices with prices paid by hospitals and large physician groups in National and Regional views of the U.S.
- Save time by quickly searching medical-surgical items via computer, tablet, or phone—available 24/7—with just a few clicks
Also affected by the addition of millions of new implant SKUs and associated price points is the Bundled Pricing Module (BPM) within ImplantDx, which provides the true costs behind the most common implant- related surgical procedures. The BPM not only gives the total costs for these procedures, it also breaks those costs down to their component parts. Complete provider-reported pricing for all 2.4 million medical-surgical implants and devices is revealed—from a $100 bone screw to a $75,000 dual chamber pacemaker. Moreover, BPM also contains complete clinical procedural reviews, CPT, ICD, and HCPCS codes, plus individually listed implant, procedure, and facility fees.
“It’s probably hyperbole to say that this tremendous expansion makes ImplantDx a million times better,” says AMS President Peter Borans.. “Of course, our clients who benefit from the addition of these implants and devices to the directory may happily disagree. I’d be okay with that!”