Reimbursement

TAMM Net will develop a plan to gain appropriate reimbursement for your product.

We start by performing an analysis of the reimbursement landscape for your product and its competition or related procedures. We provide you with candid recommendations and opinions on what is likely or not likely to be acceptable to payers, so that together we can develop an approach that has the greatest chance of success. Our relationships with payers, and the ability to relate to them in a manner that they understand, brings value to our clients.

We communicate proper coding and product introductions to private insurers nationwide and work with individual plans to ensure coverage. We continue this work with payers to incorporate your product into their clinical treatment guidelines. Working with your sales force or distribution network, we develop communication pieces for their use with their customers.

Let TAMM Net’s statisticians assess your market using the nationwide inpatient sample (nis), and discover a more efficient approach

  • Discover how many diagnoses or procedures are conducted in hospitals where your product may be used and the costs for the procedure
  • Accurately project the value of your market and forecast, analyzed by region and type of payer: private, Medicare, Medicaid, or cash
  • Discover where patients are treated or diagnosed
  • Gain an accurate assessment of the specialties and locations where your product may be used

Reimbursement tasks we routinely perform for our clients:

  • Prior Authorization & Hotline Service
  • Analysis, planning, and execution
  • Prioritize coding and identify payers
  • Integrate reimbursement into a pivotal trial
  • Attain proper coding via AMA, CMS, and BCBS association
  • Communicate proper coding to insurers
  • Get treatment into clinical pathways
  • Market assessment from payer data
  • Identify provider receptivity
  • Payer assessment
  • Health Economic Outcomes Research, HEOR
  • Payer preparation
  • Market preparation
  • Conduct competitive analysis
  • Support field sales and providers
  • Develop the reimbursement call center
  • Help resolve reimbursement issues
  • Budget impact Analysis
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