Public and Private Payer Coverage, Coding and Pricing Strategy

When clients are planning to introduce new products or services, McDermottPlus prepares coding applications and shepherds them through the ICD, CPT® and HCPCS processes. McDermottPlus works with clients to navigate the payer marketplace in which the new product or service will be sold, and to develop and implement strategies to optimize profitability.

Key Offerings:

  • Analyze clinical and economic data to determine ideal strategy
  • Prepare clinical evidence dossiers to support coverage for new products at launch
  • Prepare template reimbursement assistance documents to support the launch of new products pending adoption of new billing codes, including letters of medical necessity, claim forms, procedure reports and bibliographies
  • Analyze and comment on preliminary and final pricing determinations
  • Provide meeting support, including onsite work at the CPT® Editorial Panel meetings and annual CLFS Public Meeting