Bill-BackFor ambulatory surgery centers
Every implant you buy should be on a claim.
Bill-Back matches the supply notes from every case to the implants on your vendor invoices, prices each one at your contracted rate, and turns anything that never made it onto a claim into a payer-ready Recoup Packet.
Nurse supply note
SUT-ANCH 4.5 BIO
Invoice line
The gap
Confirming every invoiced implant made it onto a claim is nobody’s job.
Materials confirms the invoice. Billing confirms the claim.
Nobody confirms they match.
Materials & AP
Receives the vendor invoice, confirms the implant arrived, and pays it. Once the vendor is settled the job is done — nothing prompts a check that the payer was ever billed for it.
Your billing team or RCM partner
Codes and submits from the charge sheet, then works the payer's remittance. An RCM firm is measured on denial rates and days in AR — both start from a claim that already exists. Neither ever opens the vendor invoice.
Nobody opens the vendor invoice PDF and reads it line by line against the case record.
Coding and chargemaster audits check whether a documented item was coded correctly — not whether every purchased item was billed at all. That’s a different question, and nobody’s asking it.
How the miss actually happens
A nurse types the implant into the case record as free text in the middle of a procedure. The vendor invoices the same item weeks later under its own catalog number. The two strings never sit side by side, so the charge is coded from the note alone — or not coded at all.
Case record, day of surgery
SUT-ANCH 4.5 BIO
Vendor invoice, weeks later
AR-1934BC
Every nurse phrases it differently, every case, every month — there’s no volume of manual review that keeps up.
Bill-Back reads your vendor invoices against your case log for you, every month, with nothing to pay upfront.
How it works
- 1
Upload two files you already have.
Monthly case log CSV from your PMS plus vendor invoice PDFs (Stryker, Arthrex, and others). Structured patient identifiers are stripped in your browser before anything uploads, and everything we receive is handled under a signed BAA.
case_log.csvinvoices.pdf - 2
Every implant matched — you confirm what was already billed.
Nurse supply notes are matched to vendor catalog SKUs with confidence scoring, then priced at your contracted rate. Anything uncertain goes to human review — never guessed. Then you mark what your biller already put on the claim. Those drop out before a packet is ever generated.
SUT-ANCH 4.5 BIO99.1%AR-1934BCAlready billedAR-2077XLTo recover - 3
Submit the packets, mark them recovered.
Each packet is payer-ready documentation — matched invoice line, contract math, appeal letter — your biller submits to the payer. When payment lands, mark it recovered. Verified payments roll into your running recovered total and net after fees.
Recoup_Packet.pdf
- Matched invoice line
- Contract math
- Appeal letter
Recovered$1,847.00
Free to run — the fee is 15% of confirmed recoveries only.
Estimate your missed implant revenue
How many implant cases does your center run per month?
Implant cases per month
Implant value we’d identify per year
$189K–$486K
Based on ~11–14 missed or underpaid implant claims a month at $1,500–$3,000 each.
- Expected recovered
- $95K–$340K
- Net to you after the 15% fee
- $80K–$289K
Assumes 50–70% of submitted packets are paid. The most common reason a valid claim isn’t is timely filing — which is why the first month matters most.
This is a starting estimate. Each month you’ll mark which implants were already billed — what’s left is what you pursue.
Bill-Back’s fee is 15% of confirmed recoveries. You keep the rest — and pay nothing if we find nothing.
Request a live demoTalk to us
Request a live demo
We’ll walk through your own numbers and answer questions that the demo didn’t answer.
We’ll reach out within one business day to schedule.
Frequently asked questions
What exactly does Bill-Back do?
It matches the supply notes from every case in your PMS export against the implants on your vendor invoices, and prices each match at your contracted rate. You confirm which ones your biller already put on the claim; for everything left over, it generates a payer-ready packet your biller submits to the commercial payer.
Does this replace our billing team or RCM company?
No. RCM firms are measured on denial rates and days in AR — metrics that both start from a claim that already exists, and can't see an implant that never reached one. Bill-Back works the other side of that seam and hands your existing team ready-to-submit packets.
What does it cost?
Nothing upfront and no subscription. Bill-Back takes a flat 15% fee on recoveries only after the payer's payment is confirmed. If the audit finds nothing, you owe nothing.
Is patient data safe?
Two layers. First, minimization: structured patient identifiers — names, SSNs, full dates of birth, MRNs — are stripped in your browser before a file ever uploads, so they are never transmitted. Second, protection for what remains: clinical free text can still carry an incidental identifier, so everything we receive is treated as PHI and handled under a signed BAA — encrypted at rest, isolated so one center's data is never reachable from another, and every access logged to an audit trail.
Which payers does this work with?
Commercial payers (PPO/HMO, Tricare, work comp with review). Medicare, Medicare Advantage, and Medicaid are excluded — CMS bundles implant costs into the procedure payment, so there is nothing separate to recover.
What do we have to do each month?
Upload two files you already have: the case log export from your PMS and your vendor invoice PDFs. Under three minutes.
Which implant vendors are supported?
Stryker and Arthrex invoices are parsed automatically today. Other vendors are handled through manual review, and automated coverage expands regularly.
How accurate is the matching?
Every match carries a confidence score. Anything below 98% confidence goes to a human review queue — the engine never guesses, and every confirmed match is remembered so your review queue shrinks each month.
Find out what never made it onto a claim.
Free to run — if it finds nothing, you owe nothing.
Request a live demo