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Solution: Our reimbursement process.

From reimbursement strategy development, through economic modeling and clinical study design, to successful coding and coverage applications.

Reimbursement Process and Guidance

Activity Description Phase May Impact
  1. Reimbursement Landscape
  1. Money flows and financial incentives
  2. Reimbursement mechanisms
  3. Decision makers and strategy
  • R&D
  • Features and applications
  • Predicate device / intended use
  • Fundraising

    The results of Activity 1 may help choose either one of the following stories to tell potential investors:

    1. The company could commercialize its product under existing reimbursement mechanisms. Thus, it would need to convince physicians and/or hospitals (but not payers) in the clinical and economic benefits of its product compared to the currently utilized alternatives. This is a relatively short and inexpensive process; or

    2. The company will need to develop new reimbursement mechanisms. Thus, it would need to convince payers (rather than physicians and/or hospitals) in the clinical and economic benefits of its product compared to the currently utilized alternatives. This is a much longer and more expensive process.

    » These are very different stories, requiring different investments.

> More on Reimbursement Landscape ...

  1. Reimbursement Planning
  1. Value story
  2. Economic model
  3. Support of clinical data
  4. Decision makers' feedback
  5. Parallel review of regulatory and reimbursement entities
  6. Funding of clinical study by payers
  • Pre Clinical
  • Market size
  • Price
  • Clinical study protocol
  • Fundraising

    The results of Activity 2 may help tell potential investors that after we clarified the commercialization strategy in Activity 1, we also validated it with the actual decision makers (physician/hospitals or Payers) down to the required end points in the company's clinical study.

    This is like receiving the client's pre-approval to pay for a future product, if only we prove that it works as we say it will.

    » This substantially reduces the associated risk and may impact valuation.

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  1. Implementation
  1. Billing guide/Dossier
  2. Support of local medical community
  3. Prior authorizations and denial appeals
  4. Pilot projects with individual payors
  5. New reimbursement mechanisms
  • Pre Sales
  • Time to market
  • Revenue

> More on Reimbursement Implementation ...

Flat fees, concrete timelines, and support through your entire reimbursement process