In the healthcare industry, ensuring the highest quality of care while maintaining cost efficiency is a complex balancing act. A specialized Ancillary Department can play a pivotal role in helping healthcare facilities optimize their operations, enhance patient care, and ultimately save money.
Comprehensive Services in Rehab Facilities
Rehabilitation facilities offer a broad range of ancillary services including multiple therapies, X-rays, lab work, transportation and pharmacy services among others. Each of these ancillary services contributes to the overall care of patients but also adds layers of complexity to the billing and payment processes. Managing these intricacies efficiently is where a specialized ancillary department becomes crucial.
The Role of the Ancillary Department
The Ancillary Department meticulously screens all invoices, ensuring accuracy of census, payer source and contract compliance. Vendors often mistakenly bill the facility for residents who should be billed directly to insurance. Since payer reimbursement rules vary significantly, the details can become very confusing. An ancillary specialist is an expert in these nuances, reviewing each invoice to ensure there are no extraneous charges and that every single invoice is squeaky clean.
Medicaid requires itemized billing for each service, while Medicare operates on a consolidated billing system, where a single lump sum covers most services, including room and board and ancillary services. An ancillary specialist’s expertise in all payer inclusion/ exclusion details allows them to identify discrepancies, correct mistakes, and prevent overbilling.
Pharmacy Services: A Major Cost Containment Area
Pharmacy bills represent a significant portion of healthcare expenses. The ancillary team should include pharmacy specialists, who conduct thorough reviews of these invoices, identifying opportunities for cost savings.
At LTC Ally we utilize our customized software to reconcile pharmacy bills against payer source data in our system, ensuring accuracy and compliance. Our pharmacy experts scrutinize every detail, from verifying medications included in daily rates to verifying high cost medications for managed care carve outs. We also monitor changes in payer status mid-month and ensure extra medications are returned for credit when a patient leaves. By catching these details, we help facilities contain costs effectively.
Flagging Operational Issues and Enhancing Vendor Accountability
These extremely meticulous invoice reviews often uncover operational issues, which the ancillary department will flag for the facility’s attention. This proactive approach not only saves money but also improves operational efficiency.
Furthermore, consistent interactions with vendors ensure they know we are monitoring their bills closely. This scrutiny makes vendors more careful and accurate in their billing practices, further preventing overcharges and discrepancies.
Contract Analysis and Industry Norms
Beyond invoice reviews, LTC Ally’s Ancillary Department conducts thorough contract analyses for ancillary vendors, upon client request. We compare contract terms against industry norms, leveraging our extensive knowledge from working with numerous facilities. This analysis helps facilities negotiate better terms and ensures they are not overpaying for services.
Ensuring Cost Efficiency and High-Quality Care
At LTC Ally, our goal is to ensure our clients receive the best possible service with extreme attention to detail. Our Ancillary Department exemplifies this commitment by providing specialized expertise that helps healthcare facilities operate more efficiently and cost-effectively. By managing and reviewing ancillary services and bills meticulously, we help our clients maintain high-quality care while achieving substantial cost savings.
In conclusion, a specialized ancillary department is not just an asset but a necessity in the healthcare industry. It streamlines operations, ensures compliance, enhances vendor accountability, and ultimately saves money, all while maintaining the highest standards of patient care. At LTC Ally, we are proud to offer this critical service to our clients, helping them navigate the complexities of healthcare billing with confidence and ease.