Healthcare Cost Recovery Services
We understand healthcare institutions are faced with the challenging financial responsibilities of sustaining operational costs with a commitment to providing the highest quality care to your community.
While some revenue streams are not always within your control, one key area that can be directly impacted by local decisions is closely managing the procurement cycle. A healthcare institution could have the most sophisticated software and greatest employees in the industry, but when the human element is involved in any process, mistakes can and will happen.
Patients are looking for healthcare facilities offering state of the art technology, and reputable services and facilities. Hospitals operate more and more like a typical business model and understand the importance of customer relations to maintain a competitive advantage. A cost recovery project will recover lost profits that can ultimately be reinvested into the facility and its services.
How Errors Occur in the Disbursement Cycle
- Software changes or upgrades
- Personnel turnover
- Contracted pricing discrepancies
- Vendor mergers
- Health system acquisitions
- Cancelled services or product returns
- Invoice approval processes
- Delayed payments causing vendors to send duplicate invoices
- Vendor master supply files
- Simple data entry processing errors
- Multiple payment methods (AP Checks, P-Cards, ETF, etc.)
The reasons money can slip through the cracks undetected is extensive, however, the key factor is the ability to identify and recover that lost money.
Our Accounts Payable Audit and Disbursement Review is our “Cornerstone” recovery process that consists of three key areas, Electronic Payment Analysis, Vendor Statement Reconciliation, and Manual Paper Audit.
Why On and Off site work are both Important aspects to a successful review – Our goal is simple, to recover the most amount of money possible in a minimally invasive process to your daily operation. We feel our on-site work has numerous benefits that ultimately result in more recoveries for you. While onsite, we do all of our own vendor file review, scanning, analysis, and refiling of documentation and virtually answer any questions that we may have during our review process. While onsite we are also able to conduct a manual paper review which can yield large recoveries that can otherwise go unnoticed through other auditing techniques. We also strongly believe it’s important to develop a professional face-to-face relationship with you as our client.
Electronic Payment Analysis
In this process, we analyze your electronic records of invoices processed and payment history through 22 unique reports using our propriety software. We identify all matches having the slightest possibility of being an error, review the supporting documentation, and then dismiss if no error occurred or present the supportive information to your vendors if we feel there has been an error identified.
Vendor Statement Reconciliation
We know the importance of maintaining a respectful and professional relationship with all of your vendors. During this process, we strategically identify 350-2000 vendors based on your vendor disbursements that we contact to request a statement of account or aging report for reconciliation. We then analyze and reconcile the statements received against your trial balance looking for any unrecorded credit items, as well as validating your recorded liabilities to eliminate the possibility future error payments from occurring.
Manual Paper Audit
This aspect of a cost recovery audit can generally only be completed when there are paper records available. During this process, we manually review and validate the check remittance details to match the vendor invoices being paid. This part of a review can also be an area that yields the greatest recoveries as potential errors identified are not always found through the Electronic Data Analysis or recorded to your vendor Statements of Account.
Types of Recoveries Identified Through our Accounts Payable Audits and Disbursement Review
Duplicate Payments – Error Payments – Unapplied Deposits – Overpayments – Sales and Use Tax – Discounts – Allowances – Rebates – Purchasing Incentives- Product Returns –Freight – Vendor Billing Errors – Contract Cancellation/Modifications
A comprehensive analysis of contracted prices negotiated with vendors versus actual prices you’ve paid.
Our Price Analysis Review is a thorough examination of contracted prices with vendors versus actual prices paid by your Accounts Payable Department. This type of review has the potential to identify large errors because purchasing volume drives it. A difference in pennies can accumulate quickly when purchasing volume of a specific item is high. Utilizing our proprietary software (AUDEX), data is accumulated, processed and analyzed to highlight potential opportunities for recovery and/or future saving opportunities. Data is accumulated via a combination of manual (data entry) and electronic (download) protocols.
- Detailed purchase history
- Deviations to standard pricing
- Industry pricing information
Our Price Analysis Review entails accumulating, processing and analyzing your procurement/contract and payment data with special interest in adding detailed line item credit memo information to the database of purchases. By tracking purchase information for multiple fiscal periods, variations in pricing levels are flagged for further research. If pricing overpayments are discovered, we then present our findings to your vendor with supportive documentation and recover lost profits for you.
Pricing Trends Within a Vendor
We will accumulate contract and disbursement data for selected vendors, to determine and report to our clients on any unusual pricing variations. Deviations in a trend may be indicative of dropped contract price and/or higher than anticipated market pricing.
Pricing Trends Multiple Vendors
Often times the same item/product is purchased from more than one resource. By virtue of cross-referencing vendor purchases by item, regardless of the vendor, pricing variances are frequently uncovered which may provide our clients the opportunity to challenge their vendor’s pricing policies.
Future Savings Opportunities
The simple fact is… better information yields better decisions. As a result of our price analysis, The Trio Company can provide clients with information that may lead to better buying decisions in the future. We will (upon request) provide clients with our “Futures” program and fee structure.
We have perfected our claims process in that ALL of our claims are Pre-Approved by your vendors before we submit them as a recovery. We present our vendor claims as “questions” or “queries” asking them to confirm our findings or provide supportive documentation showing the corrective actions that have taken place. We then will either present to you in writing a vendor authorized deduction form to be processed and applied towards open invoices, or obtain a refund check if you have no open invoices to apply the credit against. At no point will we authorize a vendor to apply the funds to offset open invoices on your behalf. The financial decisions are to be made by your institution and we simply obtain the necessary authorization when a credit is available for deduction.
Item Master List Reconciliation
We have the ability to organize and scrub vendor and item master files to eliminate old and duplicate entries which can be a contributing factor towards duplicate or error payments being made. Particularly if there have been acquisitions, corporate reorganization, new operating systems implemented or other organizational changes where a consolidation of vendor master item lists will provide a refined foundation to your procurement process. This service is not part of our traditional contingency based cost recovery review, and can be discussed in further details as a “fee based” service.
Strategic Corporate Partnerships
In addition to our Cost Recovery Services, we have formed corporate alliances with key partners as to maximize every possible dollar to your bottom line. Fiscare is a management-consulting firm that specializes in the revenue side of the Healthcare Industry maximizing all possible receivables. Communications Consulting Services, Inc. is a partner that verifies all telecommunication billing and services are being properly billed and finds recoveries for errant billing.
We have established a corporate alliance with Communications Consulting Services, Inc. and have the ability to audit your telephone bills to ensure your phone service charges and equipment are billed accurately. View Details
Accounts Receivable and Reimbursement
This service maximizes all possible revenue through billing and collection of accounts receivable, preparation of cost reports and appeals. Our complete review is performed in association with Fiscare, and can identify revenue opportunities in areas such as; Medicare, Medicaid, HMO payments, Billing and master charge codes. View Details