The Power of Network How Helia Solves the Bill-Only Problem

Automating a broken process is not solving it. Most bill-only solutions speed up the path to reconciliation — but reconciliation is the symptom, not the problem. This white paper explains why the only real solution requires both sides of the transaction to be aligned before the order is placed, how Helia's platform achieves this at scale, and what it means for health systems, suppliers, and distributors across the country.

The bill-only problem

About 50% of a hospital’s supply chain expenditures are paid after the product has been used. Sales reps walk medical devices into operating rooms for joint replacements, spinal fusions, and other implant procedures. The case closes. The device is in the patient. And what follows is a process of manual documentation, purchase order generation, invoicing, and reconciliation that can take weeks — or months — to resolve.

The reason is not complexity. The reason is misalignment. There is no alignment between supplier and hospital about price, terms, and product at the moment the device is delivered. There is usually a contract. But that contract is not validated at the point of use.

Every step in the original bill-only process — paper forms, email chains, and manual validation — is a point where errors, delays, and disconnects can enter the transaction. Multiple departments on both sides absorb the cost. Supply Chain, Finance, Charge Audit, and Accounts Payable at the hospital. Customer service and sales operations at the supplier. All working the same transaction after the fact.

The result is a process that is financially wasteful, time-consuming, and frustrating for everyone involved. Hospital staff and leaders lack transparency and control. Suppliers wait longer to get paid because the process takes so long. And because the process can take so long, patients and their families can be affected when billing errors from missing or misrecorded devices make their way back to them.

Why existing solutions fall short

So-called bill-only solutions represent an improvement over the original manual process. They automate some steps. They surface dashboards. They alert staff when something is wrong. But the fundamental problem remains: both sides of the transaction are not aligned before the order is placed.

Automating the management of a broken system is not solving the problem. It is perpetuating it. These solutions start with data from the supplier but use data from the hospital as the source of truth — which makes the solution one-sided by design. The lack of alignment pre-transaction is what causes bill-only problems. Treating that misalignment by reconciling faster is not a fix.

Catching errors after they happen is not the same as preventing them. A cleaner reconciliation queue is not the same as no reconciliation queue.

Two ways to handle the problem

There are two approaches to the bill-only misalignment problem.

The first: deal with the misalignment by reconciling it at every step of the transaction process. This involves multiple encounters between different departments at both the hospital and the supplier. This process can be semi-automated, but the root cause — both sides not being aligned before the order is placed — is never addressed. The problem recurs because it was never prevented.

The second: stop the problem from ever happening by creating pre-transaction alignment between buyer and seller — between the hospital and the supplier — before the order is placed. This is the difference between treating the symptoms and treating the problem.

So far, the industry has only been treating the symptoms with visualization tools and semi-automated bill-only solutions that perpetuate the problem rather than stopping it from happening in the first place.

The only real solution

The only way to really solve the bill-only problem is to create pre-transaction alignment between supplier and hospital. And the only way to create that alignment at scale is to build a large network of suppliers and hospitals where contract terms, products, and pricing are loaded into the platform before any transaction takes place.

With this foundation in place, both sides of the transaction can be validated simultaneously — the health system’s contracts and the supplier’s — before the order is placed. When both sides agree upfront, the transaction is clean before it is ever submitted.

Helia validates contracts and pricing against both the health system’s system and the supplier’s simultaneously, before the PO is ever created. What was a 7-to-9 step manual process becomes one automated workflow — case closes, order validates, PO generates, invoice issues, same day.

This is not a faster path to reconciliation. It is a platform that eliminates it entirely.

What this means per audience

For health systems: off-contract items are flagged at the point of use, before a dollar leaks. Supply Chain manages by exception, not by default. Finance receives invoices that are accurate, matched to a validated PO, and on time. No vendor calls. No dispute cycles. Leadership gets real-time visibility across every bill-only transaction — what is being spent, against which contracts, before the reconciliation cycle closes weeks later.

For suppliers: invoice is generated automatically the same day the order is approved. DSO drops from months to hours for integrated suppliers. Reps place the order in Helia’s mobile app in under two minutes and receive a completion notification. No portals, no paper, no follow-up calls to the health system. The order is done the moment it is submitted.

For distributors: the entire post-case workflow — paper forms, portal logins, PO chasing, follow-up calls — is replaced by a single mobile app interaction. Case closes. Order submits. Both sides validate. Commission queued. The rep moves on to the next case.

The regulatory context

The Department of Health and Human Services Office of the Inspector General has examined bill-only solutions and found that some models may violate the Federal anti-kickback statute (Advisory Opinion No. 25-08). The OIG opinion focused on one-sided bill-only solutions — those that benefit hospitals while charging suppliers licensing fees for portal access without delivering meaningful, equal value to those suppliers.

Helia’s approach is fundamentally distinct from that model. Helia validates both sides of the transaction simultaneously and delivers meaningful value to health systems, suppliers, and distributors equally. Both sides benefit. Both sides agree before the order is placed. This is not a one-sided solution. It is a two-sided platform built to serve the entire ecosystem.

Note for Kevin: confirm inclusion of Advisory Opinion No. 25-08 before this page goes live.

The network

Helia’s platform works because both sides of the transaction are already there.

Suppliers are not joining Helia because they are required to. They are joining because the transaction is better on both sides. One major supplier completed a full API-based integration connecting to 60 hospitals and has begun recommending Helia to health systems. Other large medtech providers have integrations in progress. Large, visionary medical device suppliers have signed on, so that on average a hospital finds that the majority of its purchases are covered under the Helia platform on day one.

It has come to the point where if a supplier is not on Helia, hospitals and health systems may not want to do business with them — because the transaction is going to be enormously more burdensome compared with a Helia transaction.

As the network grows, the value compounds — for every health system, every supplier, and every rep on the platform. Building this network is not a matter of forcing suppliers to sign on. They are signing on because they see the value.

Implementation — getting started

For health systems, Helia can go live within weeks — not months — and does not require IT lift to begin. The initial process involves gathering last-12-months of bill-only case, billing, and supplier data; aligning contracts and pricing for both sides at the line-item level; deploying standardized workflows; and enabling supplier and distributor reps on the platform. Measurable savings can begin in as quickly as 10 weeks via contract enforcement, pricing compliance, and reduction of administrative overhead.

For suppliers, integration into Helia’s platform means automated delivery orders, item-level accuracy, PO matching, and clean structured data for ERP ingestion. Helia connects via APIs, webhooks, and secure file exchange — working with each customer to choose the simplest, most reliable approach.

Frequently asked questions

What is bill-only automation? 

Bill-only automation manages the entire bill-only purchasing transaction — from case close through PO generation and supplier invoice — without manual steps. The critical distinction is whether the solution validates contracts before the order is placed or reconciles mismatches after the invoice arrives. Helia validates both the health system’s contracts and the supplier’s simultaneously before the order is created, which eliminates off-contract spend at the point of use rather than cleaning it up in a reconciliation cycle.

What makes Helia different from other bill-only solutions? 

Every other bill-only solution validates against the health system’s contracts only and reconciles whatever doesn’t match afterward. Helia validates against both the health system’s contracts and the supplier’s simultaneously — before the PO is ever created. When both sides agree upfront, there is nothing to reconcile. This is an architectural difference, not a feature difference.

How long does it take to process a bill-only transaction through Helia?

Helia processes 97% of bill-only transactions touchless, with an average case-to-invoice time of 43 minutes. Traditional bill-only processes typically take 30 to 60 days from case close to invoice resolution — and often longer when pricing disputes trigger a manual reconciliation cycle.

How many suppliers and health systems are on Helia? 

500+ suppliers and distributors are already transacting on Helia, with 10,000+ contracts aligned. For health systems, that means 85%+ of their supplier base can typically go live on day one — no onboarding lag, no ramp period.

Is Helia free for sales reps? 

Yes. Helia is free for reps. No rep-facing fees, no new portals to log into, and no disruption to how reps sell. The rep places the order in Helia’s mobile app in under two minutes and receives a completion notification. Contract validation, PO generation, and invoice issuance are all automated.

How does Helia integrate with existing ERP and EMR systems? 

Helia integrates with Epic, Oracle, Workday, and Infor CloudSuite. Helia does not replace your ERP or EMR; it augments and connects them. Contract data is provided to Helia by the health system through an agreed-upon process including APIs, webhooks, or secure file exchange. The process is defined upfront with each customer based on their specific stack.