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Reimbursement Consulting: Implementation.

Applying for reimbursement codes, coverage policies and favorable payment rates.

Depending upon the existence, or the lack of, applicable reimbursement mechanisms (as identified in Activity 1 - Reimbursement Landscape), Deliverables in this Activity 3 include:

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Reimbursement Implementation


In case existing reimbursement mechanisms may be used for the new product:


Billing guide:

Develop a set of instructions guiding physicians on how to receive reimbursement following the use of the new device / drug.



Compile the Value Story, Economic Model, any published evidence and the billing guide to a dossier that would be used to convince healthcare providers to purchase the new device / drug under existing reimbursement mechanisms.

In case new reimbursement mechanisms will have to be developed:


User base:

Help establish a sufficient, documented, user-base of patients, physicians and centers using the new device / drug.


Support of local medical community:

Verify support of relevant medical societies and local key opinion leaders.


Authorizations and denial appeals:

Train physicians and develop collateral to support routine requests for case-by-case coverage and denial appeals, if necessary.


Pilot projects:

Facilitate pilot projects with individual payors.

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