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Bill-Only Implant PO Reconciliation

Bill-only PO reconciliation for implant makers that reads the sticker sheet, the rep's usage sheet and the hospital's PO together, checks each price against the contract tier, and drafts the change request a person sends.

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Follow one total knee from stamp to signed invoice ↓
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The problem

A knee implanted a week ago, and the order still disagrees with the stickers

Consigned implants are not bought until after the case. The rep turns in a usage sheet, the hospital logs the stickers, and days later its buyer raises a bill-only order from its own item master. The invoice, and the revenue, wait for that order to arrive and agree.

Customer service then holds a scanned sticker sheet, a handwritten usage sheet and a PDF order side by side and compares them by eye, line by line, against the purchasing group's price for that hospital. A wrong size, a missing patella or a line priced at list holds the whole invoice, or gets it short-paid.

Built forCustomer service repsReceivables analystsOrder-to-cash controllersSales reps

The Problem Today

After a knee or hip case, the hospital's purchase order comes days later, and often disagrees with the stickers.

9+ days
on average before a hospital sends the order, per one vendor our estimate

Compared by eye today

  • Stickers
  • Usage sheet
  • Order
  • Contract
  • One line holds it allThe hospital holds the whole invoice for one line
  • Prices drift from the tierOrders at list or an old tier slip past by eye

The Solution

  1. Three papers read togetherBarcode and print read, then matched to the usage sheet and the order
  2. Each price checkedEach order line set against the member's tier in the signed contract
  3. The fix draftedOne change request to the buyer, with the sticker images and contract
  4. A second person approvesReceivables opens the evidence, then signs the invoice

Built-in controls

  • Agents never send, change an order or sign
  • Nobody approves an invoice they prepared
  • Each revised order is checked from the start

What You Get

Invoices that match the hospital's order the first time, with the proof ready when anyone asks.

$8.49M
a year for a large maker: hours, cash and price, our model our estimate
  • Handwriting and stickers readEach sticker and handwritten line becomes a checked line
  • Late orders followed upCases waiting on a PO, chased by account on a set cadence
  • Proof on requestEach stamp, send and signature in one export
One case, one order, seven stickers

A bill-only PO for a total knee: list price, wrong insert, no patella

A cemented knee implanted from consigned stock a week ago. The hospital's bill-only order arrived as a PDF at 06:52, after the overnight run, with six lines for seven stickers.

demoHospital, implants, buyer, staff and every price shown are invented for the working solution; the figures are sample data. The patient label is masked and never read.

  1. 0109:15

    Seven stickers stamped: one off tier, one wrong catalog, one missing

    Customer service representative

    The scanned sticker sheet sits in the middle, the rep's handwritten usage sheet and the restock order on the left, the hospital's order on the right. Each sticker carries a stamp. Four are on the order at contract. The femoral component is priced off the tier, the insert has the wrong catalog number, and the patella is not on the order at all.

  2. 0209:16

    Femoral component at $2,890.00 list; the hospital's tier is $2,050.00

    Customer service representative

    She opens sticker 1. The barcode is parsed into its device identifier, use-by date, lot and serial, and checked against the printed text. Beside it: the usage sheet line, the restock line and the order line at $2,890.00. The contract price checker cites the schedule line that sets the hospital's tier at $2,050.00, $840.00 less.

  3. 0309:17

    The patella is on both sheets and nowhere on the hospital's order

    Customer service representative

    Sticker 4, a 35 mm cemented patella, was read at 97% against a 95% floor, so it counts as read. The usage sheet lists it and the restock order already replaced it, because restocking follows usage and the order type. Billing follows the order, and the order left it off.

  4. 0409:18

    One change request, three line changes, $5,176.00 down to $4,646.00

    Customer service representative

    The change drafter writes to the hospital buyer: change line 1 to the tier price, change line 3 to the 12 mm insert the sticker shows, add the patella at $310.00. Each change carries its sticker image, and the price change carries the contract page. The note is drafted, not sent. Anything she adds is marked as not compared.

  5. 0509:20

    She sends it, and the buyer has 2 business days to reply

    Customer service representative

    The request goes under her name, with the stickers and the contract page attached and no patient information. The status line moves to buyer answers, and a reply clock starts. Accounts receivable sees nothing yet; no invoice exists for this case until the order agrees.

  6. 0609:23

    The buyer opens sticker 4 and issues revision 1 with seven lines

    Hospital buyer

    In the guest view the buyer sees only her own health system's requests and their evidence. She opens the patella sticker, then issues the revised order for $4,646.00. She can also decline a line with a reason or ask a question; either would come back to customer service.

  7. 0709:26

    Revision 1 checked from the start: all seven stickers at contract

    Customer service representative

    The revised order arrived at 09:24 and was read as if new. The line matcher found 7 of 7 stickers on it, and the price checker found each at the hospital's tier with no tolerance used. Only now does the prepare button appear. She prepares invoice draft INV-D-60773 for $4,646.00.

  8. 0809:30

    Receivables reads the tier letter before the approve button counts

    Accounts receivable analyst

    She cannot approve an invoice she prepared, so it waits for him. He must open the sticker sheet, the revised order and the contract price, and each counts as read only after a few seconds open. The contract page shows the femoral component's tier prices and the letter that put this health system on Tier 2.

  9. 0909:32

    Approved with his own PIN at $4,646.00, and the invoice is released

    Accounts receivable analyst

    All three items read green. He signs with his PIN, and the meaning goes on the record with it: approved for release as matched to the order and the contract tier. The invoice goes to the ERP, and the case leaves the exception list. Had anything looked wrong he could send it back with a reason.

Six order lines at $5,176.00 become seven at the hospital's tier

Same case, same seven stickers. Restocking went ahead on its own while billing caught up.

Order as received, six lines$5,176.00
Femoral component, list to the tier price$2,890.00 to $2,050.00− $840.00
Tibial insert, catalog number correctedSame price, $690.00$0.00
Patella added+ $310.00
Revised order and invoice$4,646.00

demoSample data, from the working solution.

Four ways one total knee's order went wrong, each a different kind of fix

The stamps say which of the three papers disagrees, so the fix goes to the right person.

Priced at list, not at the tier

The hospital's item master carried $2,890.00 for the femoral component. Its purchasing group tier says $2,050.00, so the request cites the schedule line.

The planned size, not the size used

The order named the 10 mm insert. The sticker and the rep's sheet both show 12 mm, at the same price.

A component used and never ordered

The patella was implanted, logged and restocked, but left off the order. It is added at $310.00 with its sticker image.

Restock checked against the order type

Bill and replace allows the replacement already shipped. A bill-only order type would have flagged it for customer service.

demoSample data, from the working solution.

Around the case

The day's bill-only PO queue, the chase and the clean batch

What customer service, receivables and the controller work from for a whole region.

146 orders since yesterday121 matched cleanly, 24 exceptions still open with 23 change requests drafted and 2 held for a person, each with its stamps and clock.
1,284 cases with no orderBy account and days since surgery. A follow-up letter is drafted per account; customer service sends it.
Today's clean batch121 cases for $558,360.00. Receivables opens a sample of 13 chosen by rule; over $250,000 the controller co-signs.
Restock from usageReplacement lines raised from usage sheets, 600 still to ship and 34 on backorder. Restocking does not wait for the invoice.
Contract prices by tierThe purchasing group's schedule, synced at 05:40, with each member's tier and the date it began.
Write-offsRaised by receivables, signed by the controller after opening the record. The reason is typed by a person and read by a person.

demoSample data, from the working solution.

Who reads the paper

Seven agents read stickers, sheets and orders; none of them sends a fix

They read, match, price and draft. Customer service sends, receivables approves.

Sticker reader

Reads catalog number, lot, serial and use-by, and checks the barcode against the printed text.

  • Never guesses a digit; below the reading floor a person compares it
Usage sheet reader

Reads the rep's handwritten sheet: catalog, lot, quantity.

  • Never interprets the free-text note
PO line matcher

Matches stickers to order lines and stamps each one.

  • Never changes an order
  • Never matches on description alone
Contract price checker

Checks each order price against the member's tier, with the schedule line cited.

  • Never applies a price outside the signed agreement
Replenishment checker

Checks the replacement order from the usage sheet against the order type.

  • Never holds, ships or cancels stock
PO change drafter

Drafts change requests and follow-up letters with the evidence attached.

  • Never sends anything
Invoice preparer

Builds the invoice draft from the matched lines.

  • Never releases an invoice

What stays with order-to-cash people, sticker by sticker

Maker and checker on each decision that moves money.

Sending to the hospitalCustomer service sends each change request and follow-up letter. The drafter stops at the draft.
Approving an invoiceReceivables approves after opening the evidence. Whoever prepared it cannot approve it.
A sticker that will not readBelow the reading floor it is left for a person to compare by eye with the usage sheet.
Price disputesThe checker applies only the signed agreement. A dispute goes to receivables.
Money leaving the booksWrite-offs and looser settings wait for the controller, who opens the record and signs.

Where each stamp on a bill-only PO comes from

Read only. The hospital's own implant record, which carries patient data, stays at the hospital.

Intake mailbox and order feedHospital orders as PDF, fax, portal or electronic order
Sticker and usage sheetsScans and photos sent in by the rep
ERPBill-only orders, replacement orders and invoices
Contract managementPurchasing group schedules and tier letters
CRMCases, reps and accounts

What order-to-cash teams ask about bill-only PO work

What is bill-only PO reconciliation?

Bill-only PO reconciliation matches the hospital's purchase order for a consigned implant against what was actually used. This one reads the sticker sheet, the rep's usage sheet and the order together, checks each price against the contract tier, and drafts the fix when they disagree.

Does it change the hospital's order?

No. It drafts a change request with the sticker images and the contract page. Customer service sends it, and the hospital buyer issues the revised order.

What happens when a revised order arrives?

It is checked from the start, as if new, so a change made after the request cannot slip through on the old stamps.

Does restocking wait for the invoice?

No. Replacement orders follow the usage sheet and the order type. The replenishment checker only confirms that the order type allows them.

Does it read patient information?

No. The patient label on the sticker sheet is masked and never read, and the hospital's own implant record stays inside the hospital.

What about orders that never come?

Cases with no order are listed by account and age, and a follow-up letter is drafted on a set cadence for customer service to send.

Field Inventory & Supply Chain

Other order-to-cash, pricing and consignment work for implant makers

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Bring a week of sticker sheets
and the orders that came back.

We will stamp each sticker against its order and the contract, and show you the fixes to send.

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