DECEMBER 2022CIOAPPLICATIONS.COM 19PRIA HealthcareMaking Emerging Medical Innovations Accessible to Patients reimbursement strategy including coverage, coding, and payment initiatives," states Stephanie Dumont, Senior VP of Operations with PRIA.Alleviating Reimbursement Challenges in the Domain"Historically, PRIA has offered individual one-off solutions to address the unique needs of our clients. With the recent addition of several new Patient Access program services and the expansion of our strategic service offerings we are now able to provide a 360° comprehensive solution for our clients," said Kelli Hallas, PRIA Vice President.Since its initial founding in 2012, PRIA's service offerings have grown in response to increasing client demands. Although they remain focused on patient access, the increasing use of its proprietary network has allowed for the collection of real-world, real-time utilization data to support new client initiatives to satisfy requirements for establishing new CPT® and ICD-10-CM codes. In addition, this data can be leveraged to support a patient-based appeal process demonstrating clinical demand and procedure approvals, ultimately establishing positive coverage.Recently the company expanded its services to provide payment support to facilities, including hospitals and ambulatory surgery centers, on behalf of its clients. They continue to evolve and evaluate client needs and respond in real-time with new programs to support those needs. PRIA's unmatched core competencies have ignited numerous successful client collaborations since its inception, specifically securing coverage and payment for emerging technologies represented by Category III CPT® codes.Historically these codes garner "disapproval" from insurance companies, as they are deemed "experimental and investigational" due to perceived minimal levels of clinical evidence. PRIA has implemented several successful programs that have secured at least 75 percent positive coverage approval for Category III device codes, resulting in provider payment and increased device adoption.A Distinctive ApproachPRIA's in-depth expertise and proven success in providing patients with quick and assured access to medical innovations has helped numerous companies build a stable and robust business foundation. Following a tenet that highlights the needs of the four critical healthcare pillars: Patients, Payers, Physicians, and Device Manufacturers, PRIA is on a trajectory for continued service expansion to ensure that more patients have access to life-changing technologies. One of the best things about PRIA in terms of patient access is our dedicated strategic team, which has personnel with specific expertise across all facets of a medical device manufacturerClay Schwabe,VP of Business DevelopmentKelli Hallas,VP, StrategicCPT is a Registered Trademark of American Medical Association 2021. All Rights Reserved.
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