Though implants are invisible after surgery, the financial impact they have on a case is anything but. That’s because there’s a profound lack of pricing transparency in surgical implants, meaning the only sure thing is that you’ll be overpaying for implants for your injured worker cases.
Paradigm’s Surgical Implant Cost Management program rigorously evaluates surgical implants, giving you peace of mind that you’re paying the most appropriate price for every implant on every bill.
Today, 21% of surgical spend is tied to implants, and most payers are frequently overpaying due to a lack of transparency through the bill process. But with our intelligent, data-driven program, your case will be rigorously evaluated for fair and reasonable implant reimbursement, backed by full defensibility.
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Our team has first-hand operating room experience as well as surgical implant supply chain expertise, and to date, they’ve reviewed more than 200,000 implant cases totaling charges of more than $2 billion.
An independent study conducted by Boston Strategic Partners found our implant program delivered an average savings of 69%, compared to typical industry outcomes. And our program delivers defensible savings: 98% of Paradigm savings are upheld after any appeal and 88% of total bills remain undisputed.
We have more than 52,000 surgically implantable items in our Fusion by ParadigmSM platform, and it’s updated daily with the latest aggregated, geo-specific cost data, including new FDA approvals and device uses.
In contrast to AI-driven self-service platforms, we fully manage the bill review process providing maximum savings backed by our team’s extensive expertise. And our open and clear communication minimizes the administrative burden on your claims professionals.
Download our eBook for guidance on managing rising implant costs.
