How does your organization handle OEM vs. Reprocessed items - both procurement and patient charge?

Intuitive (DaVinci) items are easy - each new item has X number of uses, so interfacing a cost to a billing system (we use Epic) is very clean

But OEM vs. Reprocessed is a whole 'nuther can of worms - 1st question... do you use 1 item number or 2 (same manufacturer catalog number, different vendor)?

In a previous role, we looked historically (or leveraged our vendor) to determine the mix (on average, how many times would we purchase new vs. reprocessed, then built a fixed patient charge based on the average acquisition cost. Not perfect, but defendable - as opposed to penalizing the patient that had to pay for a new item.

Yes, reprocessed have a limited number of uses, but when purchasing, sometimes it's reprocessed and sometimes it has to be new. But from the requisitioning/purchasing perspective, how do you handle? In some areas, contractual agreements will determine how many of one or another get purchased, so sometimes it's the requester can make the determination (either by changing the vendor on the req, or just adding a line comment). But how about other areas where it's the luck of the draw? Do you always order reprocessed then have the buyers work the confirmation, creating an OEM order as needed?

Thanks in advance

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unknown

We feed Epic their SUP and BAL records from Lawson. For the DaVinci we have a Stock UOM PU (Patient Use) per EA. OEM and reprocessed have two different item numbers and two different Epic EAP numbers (Epic's version of a charge number). We put REPR-part number in the manufacturer number so the Optime users can distinguish. In the end, it's the nurse in the room responsible for knowing what they used on the patient.

ehoffman3

We also use EPIC. We build a separate Item Master record for the Reprocessed items adding a R behind the Lawson number and the Manufacturer part number if needed to differentiate the item. We handle any subdivision of the stock UOM by using the User field N1 field to pass a units/each to EPIC and they create the patient use units on their end. The clinical staff needs to know which version they're using.

unknown

I appreciate the responses - our concern isn't so much in passing a cost to Epic, but the red flag an insurance company might create, because 2 patients with the same procedure, will receive different charges.

In situations where the patient charge is based on a mark-up of the acquisition cost, the same procedure will have 2 significantly different charges. Yes, I know most is based on a fixed reimbursement, but instances like this can lead to a very slippery slope.

Worse, if this is a self-pay patient, that poor individual (pun intended) is now even poorer.

unknown

Hello,

We use one item number, two catalog numbers in Lawson, so we can source as needed. We try to purchase the reprocessed item first / always and back fill with new. We're not 100% at this but what we try to do.

The one item uses an average cost, every department sees the same cost so all benefit from the effort to reprocess. We have one cost to the patient and one charge code. That price is/can be updated quarterly as we see we've purchased more new or more reprocessed product. The patients all benefit from the savings as well this way.

Doug

unknown

Thank you Doug - at a prior organization, we also did the "one cost/one code" option. We kept a list of the items in a saved query, running that quarterly as well (looking for any significant delta). Invariably, we just updated everything once a year (along with any other fixed cost charges).

Thanks again

unknown

I would have to check with our Managed Care Contracting - but we do get audits for the patient billing all the time and provide invoicing for part numbers. That's one of the reasons why we give the reprocessed a separate manufacturer number. We're the tax district community hospital - so unless it's a self payor from out of district - I believe our Eligibility program will work to set the price at the lower procedure cost.

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