Written By: Joe Heminger, Business Development Manager

It’s April first and it’s hard enough to get through the day without some prankster trying to pull a fast on you. The last thing you want to do is fool yourself, but in our latest review of U.S. Health Systems, we have learned that that’s exactly what so many healthcare professionals are doing when it comes to managing their medical device healthcare credits.

The following list represents the TOP 3 ways in which professionals in and around the medical device warranty credit process are choosing to FOOL themselves time and time again:

  1.  You don’t closely monitor the warranty credit process because you believe your vendor has it all covered. Too often, hospital O.R. staff has relied upon the vendor to manage the device return and credit process, resulting in gaps and non-compliance. The vendor means well, but they are not the ones with real dollars at stake and they simply don’t have the same incentive to manage the process correctly. Hospitals must have an internal process to return and track the explant back to the vendor, and ensure the resulting credit is tracked, allocated and coded correctly.
  2.  You chose NOT to bring in a third-party independent auditor to check your procedure because you believe you’re doing OK on your own. The truth is, you don’t know what you don’t know. These gaps in compliance can be critical to your hospital and will determine what action the OIG takes. One small gap in compliance can cost your hospital tremendously. The most important measure you can take is to have an external, independent compliance audit of the last 4 years as the OIG found that hospitals do not conduct internal audits have gaps in compliance.
  3. You think the stakes are low and it is just a simple matter if paying back unreturned Medicare credits. There is so much more at stake than you might imagine. The OIG is targeting all U.S. Hospitals in their latest audit. If/when they find proof of an improper payment, they will claw back the amount of the payment, plus a penalty equal to three times the amount of the payment, plus an additional fine of $11,463 up to $22,927 per each infraction. And what’s worse is that hospitals that are shown to have made several egregious errors may be placed on an excluded list and prevented from taking future Medicare reimbursements. And even worse, in cases where deliberate fraud is detected, a Health System executive may be forced to serve jail time.

So please don’t fool yourself! It really isn’t so easy to track every single medical device credit on your own. Too much can go wrong from removal to coding compliance, and far too much is at stake.
Talk to SpendMend about simple strategies you can use to ensure historical and future compliance, no foolin’!