Our Reimbursement Experience

With 50+ years of combined healthcare policy and finance services experience, MCRA’s medical device reimbursement team guides companies through multiple healthcare economic pathways: from technology development to commercialization and beyond. MCRA’s reimbursement services are unique and effective in assisting companies in achieving commercial success. We have the preeminent medical reimbursement consultants for evaluating existing and novel technologies’ current and future reimbursement coding, coverage and payment options, and we work to achieve your company’s goals of impacting trends and changes in healthcare policy. A strong reimbursement program improves product utilization and acceptance, and helps physicians and providers understand how they will get reimbursed for using a medical device.

Medical device reimbursement requires day-by-day planning and operational execution equal to a company’s other departmental requirements, such as sales and marketing, accounting/finance, and clinical/regulatory. MCRA’s healthcare reimbursement consulting focuses on assisting clients on a daily basis to ensure appropriate coverage and reimbursement for medical devices and related procedures. MCRA’s coding, reimbursement, and compliance experts have over 50 years of combined healthcare policy and finance services experience, and have a proven track record servicing over 250 clients nationwide.

Patient Access Programs

Reimbursement is the most complex and significantly changing dynamic in healthcare technology commercialization today. New governmental healthcare laws, fee schedules, coding changes, and clinical utilities are placing financial pressures on patients, providers, and payers. Both small and large medical technology companies are highly affected by these dynamics. MCRA believes successful reimbursement execution, based on an evidence-based clinical approach, is necessary to achieve successful commercialization and coverage of innovative technologies.

An innovative and proactive approach to understanding how a new technology will integrate into the coverage landscape results in a host of service offerings including:

  • Technology specific coding
  • Case specific benefits verification
  • Pre-authorization support
  • Denial appeals
  • Payor outreach alternatives

Clinical Trial Reimbursement Services 

MCRA can help you save time and money by strategically planning your clinical trials to collect the imperative clinical data sufficient for both regulatory approval and successful reimbursement.

MCRA's Clinical Trial Reimbursement Services:

  • Evaluation of clinical study protocols from a reimbursement perspective
  • Appropriate coverage during the trial (Medicare and private payors pathways)
  • Administrative budget development and procedure benchmarking
  • Clinical trial site support and training materials
  • Collection of claims/payment data
  • Coordination with IRB on payment and billing processes during the trial
  • CTA Negotiations

Our Integrated Approach

MCRA’s medtech reimbursement consulting team understands that your company’s concerns - tight financing, inadequate time, too much competition, and quickly changing regulatory requirements and reimbursement landscapes – require your company to rapidly commercialize your technology or miss being ahead of the curve. We believe the most integral part of the commercialization process is appropriate coverage and payment, because without sufficient reimbursement, a medical technology company will not survive.

Prior to product commercialization, MCRA’s reimbursement consultants for medical devices can assist in strategically planning your clinical trial to collect the important clinical and health economic data sufficient for both regulatory approval and successful reimbursement. During the trial, MCRA can work with and advise management, individual sites, and payors on the availability of appropriate coverage and reimbursement pathways, which ultimately takes a large burden off of your clinical trial sites and streamlines the clinical trial and subsequently, time to market.