Strategic planning for Medicare, Medicaid and commercial payer reimbursement of a new or existing medical device, drug or biological is a key element to its success.
Let Nusgart Consulting be your guide.
Medical device, drug, biological and durable medical equipment (DMEPOS) manufacturers may find that these processes have become extremely and increasingly complex. Each element has its own set of regulations that are lengthy, confusing, difficult to find and maneuver, and ever-changing. Many organizations may not have the in-house expertise to navigate their product through the processes that govern coding, coverage, and payment. Others may simply need some strategic guidance to create and navigate HCPCS coding applications and coding verification applications smoothly, quickly and predictably. We provide guidance throughout the reimbursement process:
- We understand and successfully navigate the political nuances that underlie Medicare coding, coverage and payment processes.
- We have strong relationships with decision-makers at the relevant Agencies (CMS coding, coverage and payment staffs; DMEMAC and A/B MAC medical directors; PDAC medical director and staff; FDA). We’ve been in this space for 25+ years. We know the senior staff, the policymakers, and the decision makers. We not only have their contact information, but more importantly, we have their respect.
- We possess vast technical and historical knowledge of coding, coverage and payment processes.
- We understand the manufacturers’ challenges and perspectives.
- We have a proven track record of success in assisting manufacturers in obtaining positive HCPCS coding and coding verification decisions
We support clients with a range of services that include:
- Developing and implementing coding, coverage and reimbursement strategies throughout the product development lifecycle for new or existing medical devices, biologicals or drugs
- Focusing on the best data to support your application: The outcome of coding and coverage requests can rest on the type and quality of the data provided. Nusgart Consulting advises companies on the type of data needed to support a successful coding and coverage strategy.
- Coordinating educational programs for companies, their staff, their sales teams and their customers on issues regarding coding, coverage, and reimbursement. Development of training and “how to” guides.
- Convening aligned stakeholders and/or establishing of coalitions of patient and professional groups together with industry to provide collective power, credibility and expertise for lobbying legislative bodies and regulatory agencies regarding coding, coverage, and reimbursement under Medicare, Medicaid, and commercial payers
- Working in tandem with regulatory teams to help coordinate the FDA registration process with the HCPCS coding processes and time them accordingly. Help manufacturers understand how decisions about FDA applications and designations impact reimbursement strategy.