FINDING AN ALTERNATIVE ROUTE TO REIMBURSEMENT
A medical device venture offers a prosthetic/orthotic product that benefits patients in both hospital and home health care settings. However, no billing mechanisms were in place to support this product’s use in either environment.
Working in close collaboration with the client and insurance organizations, we identified a billing pathway for the device.
To drive this agenda forward successfully, we conducted detailed research and interpretation of existing billing and payment guidelines. In addition, we represented the client’s interests throughout rigorous fact-finding and intensive ongoing dialogue with Medicare, hospitals and home health agencies.
Ultimately, we helped open the door to more widespread use of an item for which healthcare organizations previously were unable to bill.
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