Specialty Nurse and Implant Review

September 22, 2021

Medical tools used for an implant procedure laid out on a tablecloth

Implant Review Helps Large National Payor Save

Industry-wide, implant billing is marked up an average of 400%. CERIS defends against these markups with a differentiated Implant Cost Database coupled with clinical expertise.

CERIS leverages implant charge data by area and manufacturer costs via its proprietary national database. Once processed through the database, CERIS’ surgically trained nurses make sure the implant quantities and area of insertion are FDA approved.

No one else could offer the clinical application review and repricing of the implant with a solid database. Their actual nurses and defensible data made the decision to work with CERIS simple - CERIS has a distinctive offering.

On an annual basis, CERIS’ implant program saves this client over $1,200,000.

For one particular claim, suture anchors were billed for knee surgery. On average, these cost $1,500 each. The hospital invoiced for a full package, which includes six anchors. This particular procedure only requires two anchors. CERIS’ Specialty Nurse Review team had this knowledge and was able to flag and remove the four unused implants from the bill, saving the client $6,000 with a single line item.

CERIS saves an average of 62% per implant claim ensuring all aspects are correct and repriced to the manufacturer’s implant cost through our proprietary repository of national implant invoice data. CERIS provides clarity at reasonable and transparent pricing.

Let's partner to a clear path to greater accuracy and cost savings.

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