Our clients hire us because we have the experience, strategic insight, and judgment to answer critical marketing and reimbursement questions rapidly and with a minimum of investment. After 26 years in the consulting business, we have the experience that our clients value.

• Due Diligence:

  When venture firms or investors evaluate a new technology, they may engage us to provide a reimbursement assessment. We evaluate payment for comparable products, survey private and public health plan medical directors about their possible policy decisions, gather published data on current fee schedules and other payer reimbursement, and evaluate potential pricing. Our report summarizes reimbursement issues facing the product and advises on how to achieve successful coverage, coding, and reimbursement.

• Strategic Planning:

  Companies invite Maren to serve on expert panels or do research as part of a strategic planning project. Typically, the firm is asked to analyze how public policy changes and reimbursement or market trends will affect demand for certain product segments. We may suggest areas for future R&D research based on health care financing trends.

• Market Studies:

  We gather data and estimate market size (number of potential and actual patients), physician demand and potential usage over time, competitive products (in development and on the market), potential pricing, and future revenue.

• Reimbursement Planning:

  Most innovative health care products require specific payer policies on coverage, codes, and payment. We help companies develop a strategic and practical reimbursement plan that will ensure rapid payer adoption when the product is launched. We determine which third-party payers cover the targeted patients; contact managed care plans, Medicare, and Medicaid programs about coverage and payment levels; estimate payer fees for procedures and products; outline the steps in applying for new codes, and provide a detailed timeline for obtaining successful insurance policies.

• Reimbursement Launch, Monitoring and Troubleshooting:

  Favorable reimbursement facilitates marketing success for new products. We work with manufacturers to "sell" products to insurance companies, including developing the economic and clinical dossier of information that evidence-based payers require before making a coverage decision. We also contact professional societies and technology evaluation committees to be sure that clinical data are understood and products are endorsed properly to payers. We follow-up with payers to be sure that coverage and reimbursement processes are underway and that claims are being paid. If necessary, we can work with company staff or customer billing people to resolve problem claims.