Holistic Approach. True Savings.

Surgical implants are one of the most cost-inflated areas in workers’ compensation (WC). Implantable devices, ranging from pins, rods, and screws to total knee replacements, are marked-up on average 300 to 500% in the WC market.

As a pioneer in the WC market for implants cost management, our three-tiered Surgical Cost Containment Program® (SCCP) makes us one of the only providers who delivers a holistic approach to surgical cost containment. With a market-leading success rate, SCCP produces savings as high as 50% below fee schedule for surgical implants.

Moving Forward. Working Together.

In every step of the recovery process, we work collaboratively with claim professionals, case managers and provider partners to deliver an integrated solution that expedites positive outcomes for injured workers and savings for our clients.

 

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SCCP models can be applied individually or as a continuum.

Pre-Negotiation procedure and implants

A rate is negotiated for the entire surgery that is below fee schedule. The negotiation includes, but is not limited to, facility fees, physician fees and implants. A signed agreement is obtained from the facility prior to the surgery.

Prospective implant carve-out

Implants are procured at reduced rate and the estimated fees are provided to the client prior to surgery. The coordination among the hospital/ASC, physician, manufacturer and client is seamless with no interruption of care.

Retrospective post-surgery negotiation

This model leverages existing contracts and historical data to negotiate appropriate reductions below fee schedule for total surgery costs or implant-only charges.

Program Features

  • Prevents facilities from marking-up surgical hardware, biologics and implantable components
  • Drives savings with no risk to injured worker or quality of outcome
  • Delivers deeps discount without PPO fees
  • Establishes predictable pricing and appropriate billing for accurate reserves setting
  • Provides opportunity for additional cost-savings after traditional bill review repricing
  • Offers the efficiency of having pre- and post-operative care services provided by a single source

 

The overriding goal of Orchid is helping injured workers get back to work and back to life quickly and cost-efficiently as possible. Contact us to learn more.