Product & Vendor Catalog
Centralized product, pricing, vendor, and operational rule management.
Products
128
In active catalog
Active Vendors
14
Under contract
Require Measurements
36
Compression products
Require Prior Auth
22
Insurance requirement
Catalog Inventory
8 of 8 products
| Product | Vendor | Cost | Billable | Margin | Measurements | Prior Auth | Status |
|---|---|---|---|---|---|---|---|
Compression Sleeve – Grade 2 | Juzo USA | $90 | $225 | 60% | Required | No | Active |
Lymphedema Kit – Full Arm | Solaris Medical | $145 | $380 | 62% | Required | Review | Active |
Breast Prosthesis – Custom Fit | Amoena Care | $210 | $495 | 58% | No | Required | Active |
Compression Garment – Lower Limb | Medi USA | $120 | $315 | 62% | Required | No | Active |
Compression Stockings – Class III | Medi USA | $78 | $195 | 60% | Required | No | Active |
Lymphedema Sleeve & Gauntlet | CircAid Medical | $155 | $395 | 61% | Required | Review | Active |
Post-Mastectomy Bra | Amoena Care | $85 | $210 | 60% | No | Required | Active |
Arm Sleeve – Post-Op Grade 3 | Juzo USA | $95 | $240 | 60% | Required | No | Active |
Operational Rules
Business rules that drive workflow behavior
Measurements required for compression products
Certified therapist measurements must be uploaded before an order can be processed.
Prior authorization required for breast prosthesis orders
PA documentation must be verified with the insurance provider before fulfillment.
Minimum margin threshold: 30%
Orders below 30% margin are flagged automatically for manager review before approval.
Preferred vendors selected automatically
Vendor selection is driven by margin performance, fulfillment speed, and contract terms.
Vendor contracts reviewed quarterly
Pricing and contract terms are audited and updated each quarter.
Pricing Logic
How billable amounts are calculated
Vendor Cost
Base cost sourced from active vendor contract.
Fee Schedule Adjustment
Adjusted to the insurance plan's fee schedule rate.
Insurance Rules Applied
Plan-specific rules, co-pays, and coverage limits applied.
Margin Calculation
Margin computed as (Billable − Cost) ÷ Billable.
Final Billable Amount
Confirmed amount passed to invoice generation.
Calculations are managed in the catalog. No hidden spreadsheet formulas.
AI Opportunities Roadmap
Potential workflow enhancements identified during process analysis.
Vendor Recommendation Engine
FutureCurrent Process
Operations staff manually compare vendors based on pricing, margin, and fulfillment performance for each order.
AI Opportunity
Recommend the optimal vendor using historical profitability, fulfillment speed, inventory availability, and regional performance data.
Expected Impact
↓ Reduce vendor selection time by 60%
Prior Authorization Prediction
FutureCurrent Process
Teams manually determine whether insurance prior authorization may be required before order submission.
AI Opportunity
Predict authorization requirements before order submission using historical approval patterns and insurance plan data.
Expected Impact
↓ Reduce processing delays and rework
Pricing Anomaly Detection
FutureCurrent Process
Managers manually identify unusual margins or pricing inconsistencies during the order approval review.
AI Opportunity
Automatically detect abnormal pricing behavior, low-margin orders, or potential billing errors before they reach the approval queue.
Expected Impact
↓ Reduce approval escalations
Fulfillment Routing Optimization
FutureCurrent Process
Fulfillment teams manually select fulfillment paths and vendor assignments for each approved order.
AI Opportunity
Recommend optimal fulfillment routing based on geography, inventory levels, vendor performance history, and delivery SLAs.
Expected Impact
↑ Improve delivery speed and operational scalability
Estimated Business Impact
Projected outcomes based on comparable operational workflow improvements.
These opportunities are not part of the current MVP and represent future AI-enabled workflow enhancements identified through process analysis.