Workers' Compensation Because implants are carved out of most state fee schedules and are often paid on a percentage of billed charges, hosptials bill more in order to profit more. As a result, paying hospitals or surgery centers for implants based on invoices often results in paying significantly more than necessary. In many cases, invoices may be marked up by 300% - or more. As much as 30% of workers' compensation hospitalizations involve spine implants. A large percentage of these invoices are inaccurate and some are overstated in many ways. Without medical expertise and knowledge of hospital/ASC implant products and procedures, you may never realize the extent of the overcharges. Following are five common ways that medical implant charges are inflated: Invoice includes items that are unrelated to the patient or procedure Off-label items are included on the invoice Hospital charges you for items wasted by the operating room staff or surgeon The hospital’s promotional discounts and/or rebates are not reflected in their invoice FAIRPAY's Implant Cost Containment solution identifies implant overcharges and helps payers cut costs by determining the facility's "real" net cost for implant procedures. We then adjust the bill based on all applicable jurisdictional requirements. Our data includes information on virtually all implants, including spine surgery, orthopedic implant procedures, cardiac rhythm management, stents, pumps and other implantables. Our data-driven review enables FAIRPAY to determine the facility's real cost, less any rebates or promotions. We use this as the starting point for our repricing process. Starting at the absolute bottom line ensures the accuracy and defensibility of our pricing recommendations.