![]() WellPoint) and managed care organizations such as Kaiser, GroupHealth Cooperative and HealthPartners. Commercial or private insurance plans include Blue Cross/ Blue Shield, Prudential, Aetna, Cigna, United. Government reimbursement programs include Medicare, Medicaid, TRICARE/CHAMPUS, and the Veterans Health Administration and Workers’ Compensation. To start at the very beginning, third party payers are entities or organizations that pay for some or all of a person’s medical expenses. Understanding the reimbursement process is complex and specialists are often hired to take the company through the reimbursement maze. Without reimbursement, the business model for your new device is not likely to be viable. Reimbursement is essential because no patient pays for a medical device out-of-pocket but rather the cost is payed by a insurance company. ![]() For example, approval for reimbursement almost always requires publication of research studies in peer reviewed journals as the evidence supporting your claims about your device. Reimbursement is a higher bar than approval because along with proving that your device is safe and effective, you must prove that your device is cost-effective. Reimbursement by third-party payers is a separate process from regulatory approval, although without approval there will be no reimbursement. Reimbursement requires evidence to support claims that a technology leads to better patient outcomes at lower cost than existing solutions Introduction to Reimbursement
0 Comments
Leave a Reply. |
AuthorWrite something about yourself. No need to be fancy, just an overview. ArchivesCategories |