The surgical centers and hospitals that purchased their implants from Access MediQuip will have to find another source for their implantable devices. Last week, the nation's first and largest provider of outsourced surgical implants closed its doors.

"Access MediQuip is undergoing a corporate restructuring," says the company in a statement. "As part of this process, our division that focuses on implantable device procurement and management will cease operations."

Beacon Device Services, a division of Access MediQuip with 40 employees, is continuing operations, says the company. Beacon specializes in pre-authorization of implantable medical devices for hospitals and surgery centers on behalf of major medical device manufacturers.

Access MediQuip, founded in 1997, let surgical facilities host expensive cases with essentially no financial risk. The company purchased implantable devices such as orthopedic and spinal implants, and implantable drug pumps from the manufacturer, delivered them to the facility and billed the commercial payor for its cost. Surgical facilities were drawn to the service because they didn't have to worry about whether insurers would reimburse the implants, which often times cost more than the surgery itself. Plus, surgeons were happy because they could use implants of their choice.

One ASC administrator who's been using Access MediQuip just about every day for close to 2 years is left scrambling to figure out how her implant vendors will be paid. "We do cases that use thousands and thousands of dollars worth of implants," says the administrator, who asked not to be named. "Our managed care contracts stipulate that we must use a third-party implant billing company."

The administrator says she was a satisfied Access MediQuip customer. She appreciated not having to deal with the vendors or the payors. Access handled purchase orders and paid her implant vendors in a timely manner. Things started to change recently, however. "I never ever heard any complaints until the past 3 or 4 months, when a couple of vendors said it was becoming more and more difficult to get paid."

Purchasing an implant you might not get reimbursed for is a risk you'd rather not take. This is where implant billing companies come into play. You're probably aware of how they work: Typically they buy the implants, charge the insurance carrier directly for all devices used during the procedure and assume the responsibility and risk of obtaining reimbursement, letting you essentially host expensive cases worry-free. "They absorbed all of the costs and I never saw the bill," says one user. "It was a very easy process."

Dan O'Connor