Obtained local Medicare and third-party payment for breakthrough medical devices and diagnostics in the following areas:
- Cardiovascular implants
- Electrophysiology
- Cardiac monitoring
- Urinary incontinence
- Ultrasound
- Orthopedic implants
- BPH Therapies
- Tissue substitutes
- Wound healing therapies
- Bladder cancer diagnostics
Secured national Medicare coverage for the following devices that were not covered:
- Left ventricle assist devices
- Thoracic electrical bioimpedence
- Pelvic floor stimulation
- External counterpulsation
Assisted in securing CPT codes in the following areas:
- Cardiovascular
- Orthopedics
- Urology
- Gynecology
- Interventional radiology.
Established ICD-9-CM procedure codes for:
- Cardiac assist devices
- Therapeutic ultrasound
- Cardiomyoplasty
- Cardiac support device
Established and/or revised HCPCS Level II codes for:
- Phototherapy lamps
- Infusion Pumps
- Biologic non-human tissue
- Urologic bulking agents
- Respiratory products
Secured hospital outpatient transitional pass-through and new technology designations in the following areas:
- Interventional radiology
- Cardiology
- Urology
- Pulmonology
- Electrophysiology
- Gynecology
- Using an economic model for a new diagnostic device, demonstrated an increase in the value of the new technology over standard diagnostics of $2000 to $3000 per diagnosis.
- Developed an economic model for an intravascular device showing that payers would break even if the procedure for the new device were reimbursed at $3000 more than the current technology due to cost savings within the healthcare system.
- Developed a meta-analysis of a tried-and-true technology whose coverage was recently cancelled by a major payer. The analysis showed a substantial benefit of the technology, contrary to the mixed results of the single study that the payer had used to justify its coverage cancellation.
- Provided reimbursement data that has facilitated several merger and acquisitions.
- Provided input to venture capital companies to assist with investment decisions.
- Worked with a world leader in medical device design to provide insight for designing devices that will secure maximum reimbursement.
- Assisted thousands of providers (hospitals and physicians) in understanding coding, coverage and payment for our clients via on-site training, webcasts, reimbursement guidelines and reimbursement support lines.
- Trained hundreds of sales representatives on reimbursement for their products and procedures.
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