Our services.

Comprehensive services to help you develop the necessary evidence for payer reimbursement decisions.

Evidence Review and Assessment: Thorough evaluation of existing data and evidence to support payer requirements, identifying gaps and opportunities to fill those gaps from the payer perspective.

Clinical Trial Protocol Development & Guidance: Tailored protocol design and/or review that aligns with payer priorities so that analytic validity, clinical validity, and clinical utility studies generate relevant data for reimbursement considerations.

Publication Planning: Strategizing and planning publications that highlight the clinical and economic value of your product to strengthen payer engagement.

Clinical Dossier Writing: Crafting scientifically robust dossiers that effectively present clinical and economic evidence to payers and regulatory bodies.

Create a strong market entry strategy by focusing on competitive insights and key stakeholder engagement.

Product & Reimbursement Roadmap Development: Aligning quality, regulatory, reimbursement, and commercialization strategies to support a successful product launch.

Competitive Analysis: In-depth analysis of market dynamics, competitor strategies, and payer landscapes to guide your positioning.

Target Customer Profile Development: Identification of key customer segments, tailoring your offering to meet the specific needs and preferences of your target audience.

Key Opinion Leader (KOL) Support Strategies: Developing strategies to engage KOLs and influencers, ensuring they advocate for your product in relevant healthcare settings.

Maximize market access through strategic payer planning, engagement, and policy alignment.

Medicare Coverage Technical Assessment Support: Expert analysis of Medicare policies and coding requirements to help you navigate the complexities of reimbursement.

Medical Policy Reviews: In-depth review of payer policies to ensure alignment with your product’s clinical and economic value proposition.

Value Proposition and Evidence Package Development & Review: Tailored packages that clearly articulate the value of your product, showcasing the evidence needed to secure payer approval.

Payer Presentation & Outreach Support: Professional preparation of payer presentations and other outreach materials to communicate a clear and persuasive value proposition.

CPT coding and pricing strategy assessment to support a sustainable business model.

CPT Code Application Support: Providing guidance on the use of codes for optimal reimbursement, including applying for new codes when warranted.

Strategic Pricing Guidance: Creating a pricing strategy and list-price analyses to support sustainable commercial goals while maximizing payer acceptance.

Medicare Operations Expertise: Subject matter experts to support appropriate payment for your product, including Gapfill or Crosswalk analyses for lab testing.

Ad-hoc Questions and Access to Certified Coders: Access to certified coding experts who can answer your specific coding questions and provide ongoing support.

Support execution of payer coverage and contracting strategies to promote patient access to care and drive a sustainable business model.

Payer Outreach Strategy: Developing payer outreach strategies based on company objectives to create an achievable outreach plan.

Payer Policy Support: Preparing and engaging with medical policy, including messaging and delivery of value proposition.

Provider Relations Engagement: Planning and execution of in-network contracts.

Advisory Boards: Coordinating advisory boards with payers and key stakeholders to inform strategy and promote ongoing payer support.

Bridge the gap between billing and market access teams to drive policy, optimize reimbursement and collections.

Claims Enhancements: Identifying and implementing improvements to streamline claims processes and increase collections.

Appeals Strategy: Developing effective appeals strategies to challenge claim denials and secure appropriate reimbursement.

Third-party or In-house Billing Support: Offering both third-party billing solutions and in-house support to promote efficient revenue cycle management practices.

Billing Policies & Implementation: Reviewing and developing billing procedures that align with policy requirements and company goals.