Your Success in Reimbursement

Reimbursement is critical to market success for products that are administered in hospitals or clinics. BMS advises planning for reimbursement at every stage of product development. Reimbursement issues, such as whether new or existing medical codes are appropriate, affect regulatory choices in product claims and labeling and (for devices) whether to prepare 510(k) vs.PMA applications.

These issues in turn affect clinical studies, including indication for use, patient population and clinical endpoints. In addition, reimbursement needs frequently entail the collection of data on medical economics during clinical studies. Lack of appropriate and convincing economic data can add years to your timeline to profitability.

To provide strategies and solutions that help our clients achieve favorable coverage decisions and adequate payment for their products.

1. Reimbursement assessment
2. Outcomes studies, reports, and publications
3. Medical economic studies and modeling
4. Applications for new HCPCS, CPT and/or ICD-9-CM codes
5. Coverage policy proposals and technology assessment reports
6. Proposals to Medicare and other payers to address outmoded payment classifications
7. Product awareness with key administrators and thought leaders.

1. BMS offers a comprehensive approach that considers reimbursement issues at all stages of product lifecycle
2. BMS helps clients strategically evaluate coding, coverage, and payment issues for their impact on physicians, hospital administrators, and third-party payers
3. BMS helps clients understand how product design, clinical needs, regulatory decisions, and marketing plans affect reimbursement levels and timelines to profitability
4. BMS stays current on changing health care policies.