Bill-Back

IMPLANT REVENUE RECOVERY FOR ASCs

We find the implant revenue your billing workflow isn’t built to recover.

Bill-Back checks your vendor invoices against your case log and payer contracts, line by line, to find implant carve-outs that were never billed or were undercharged. Then it hands your biller or RCM partner a corrected claim for each one.

Get your free implant audit

Free to audit. Works alongside your existing biller or RCM.

See how it works

The gap

Three places implant revenue slips between the OR and the payment.

Each system is accurate on its own. ASC billing software isn’t built to compare them.

  • The claim uses the cost on file.

    The Item Master holds an older price, so the charge goes out low and the payer pays on it.

    What Bill-Back does

    Compares it to the invoice and your contract, then to what was billed.

    UnderchargedRead more

  • The invoice arrives after the claim.

    Consignment and bill-only invoices reach accounts payable weeks later, matched to a PO, not to the case.

    What Bill-Back does

    Matches late invoices back to the case and shows what never reached a claim.

    Carve-out missedRead more

  • The claim carries a code, not the device.

    Many catalog numbers share one HCPCS code, and a missing or generic one can leave the carve-out unapplied.

    What Bill-Back does

    Maps each implant to the code your payer expects and checks whether it made it onto the claim.

    Carve-out missedRead more
One case, implant by implant.Illustrative example.
ImplantContract priceBilledResult
Interbody cage 10x26$4,895$4,290Potential undercharge $605
Pedicle screws (4)$2,640$2,640Already billed
Rod 5.5x80$410$0Carve-out missed
See one case in detail

Charge created on an outdated cost

Illustrative example.

Clinical record

Case log · 4452

Mar 20

Supply note

TLIF CAGE 10x26

Billing

Claim · 4452

Mar 23

122633Lumbar fusion, TLIF
2L8699Interbody cage

Item Master cost on file

$3,900

Accounts payable

Stryker Corp.

Apr 13

SY-4826010

Titanium Interbody Cage 10x26mm

Invoice cost

$4,450

Cost-plus 10% contract

Billed

$4,290

On invoice cost

$4,895

Potential undercharge $605

Case costing uses the same cost on file, so the case still looks profitable.

Each document looks right on its own. It’s a design limitation, not a team failure.

Bill-Back lines up your supply notes, vendor invoices, payer contracts and Paid Claims Report, then shows which implants were already billed, missed as carve-outs, or undercharged. You confirm any match under 98% confidence.

Get your free implant audit

How the free audit works

  1. 1

    Upload the files you already have.

    We'll walk you through it. Only what the audit needs is sent. The file itself never leaves your browser.

    case_log.csvpaid_claims.csvinvoices.pdf
  2. 2

    We find what's unbilled or undercharged.

    We match supply notes to invoice lines and check them against your Paid Claims Report. You confirm anything we're unsure of.

    CANN SCREW 4.0x4098.7%
    SY-7050425Already billed
    AR-2077XLCarve-out missed
    SY-2104508Undercharged
    AR-3310TKNeeds review
  3. 3

    Your biller or RCM submits. You get paid.

    Each unbilled or undercharged implant gets a corrected claim, packaged as a Recoup Packet, for your biller or RCM partner to file.

    Recoup_Packet.pdf

    • Corrected claim
    • Contract basis
    • Exhibit A: invoice line
    Recovered$47,838

See what your center could be recovering

Implant cases per month

Your estimated annual recovery

$189K–$378K

Implant carve-outs missed at billing
7% of implant cases × $1,500–$3,000 each × 12 months

Annual estimates. Your audit shows your actual numbers.

You only pay on confirmed recoveries.

Get your free implant audit

Talk to us

Start your free audit

We’ll walk you through the upload. No cost, no commitment.

We’ll reach out within one business day to schedule.

Number of centers

Patient data is minimized in your browser and handled under a signed BAA.

Frequently asked questions

What it does

Does this replace our billing team or RCM company?
No. RCM firms are measured on denial rates and days in AR: metrics that start once a claim exists. An implant that never reached a claim, or went out on an outdated cost, doesn't register in them. Bill-Back works that seam. Your biller keeps billing, your RCM keeps working claims. We hand them corrected claims, ready to submit.
How accurate is the matching?
Every match carries a confidence score; anything below 98% goes to a human review queue instead of auto-approving. Confirmed matches are remembered, so your review queue shrinks month over month.

Cost and effort

What does it cost?
Nothing upfront, no subscription. We're paid a flat contingency fee only after the payer's payment is confirmed. If the audit finds nothing, you owe nothing.
What do we have to do each month?
Upload three files you already have: case log, Paid Claims Report, and vendor invoice PDFs. The Paid Claims Report is the export from HST Pathways or SIS. Under three minutes. Invoices don't need to match the case month; upload them as they arrive and we'll match against your recent case logs.
We chart and bill in HST Pathways, SIS, or Advantx. Isn't this already handled?
Charting and billing in one platform gets the implant note onto your charge sheet. But creating the charge isn’t checking it against the invoice. The number comes from your Item Master, not what the vendor billed. Bill-Back reads both and shows you what never made it onto a claim and what was charged on an outdated cost.

Data and coverage

Is patient data safe?

Yes, in two layers:

  • Minimization: your file is read in your browser, and only what the audit needs is sent: procedure month, payer, CPT code, procedure description, surgeon name, and supply notes. The file itself never leaves your browser. If you map a case or account number, it is hashed in the browser before it’s sent, so the number itself never leaves your browser.
  • Protection: supply notes are sent as the nurse wrote them, because the device description and catalog number are what the audit matches on. Everything sent is handled under a signed BAA, with encryption in transit and at rest, facility-level isolation, and append-only audit logging.
Which payers does this work with?
Commercial payers (PPO, HMO) plus work comp through manual review. Medicare, Medicare Advantage, and Medicaid are excluded: CMS bundles implant costs into the ASC’s procedure payment, so there’s nothing separate to recover.
Which implant vendors are supported?
Stryker and Arthrex are supported today. Other major vendors (Zimmer Biomet, DePuy Synthes, and more) are fully supported through manual review, and new invoice layouts are added as centers send their invoices.

Find your unbilled and undercharged implants.

Free to audit. You only pay when the payer pays.

Get your free implant audit