Outsourced Field Reimbursement Team Overcomes Reimbursement Barriers

Situation
A mid-size biotech company is launching a new physician-administered product into a market with one entrenched competitor. The competitor’s product is self-administered.

Challenge
The product requires significant reimbursement education, including roll-out and explanation of coding and billing guides. It is important to ensure that providers and staff are confident in their ability to utilize the product and secure reimbursement.

Actions
Anticipating a high volume of issues immediately following the launch, the client deploys 10 Field Reimbursement Managers. Taking direction from the client’s sales representatives and area managers, the team focuses on educational programs and site visits where providers are experiencing the most pressing reimbursement challenges. After 6 months, the team easily reduces headcount to 5 Field Reimbursement Managers.

This team continues to answer questions and provide ongoing support when sales representatives identify reimbursement issues at the provider level. Despite high turnover in provider administrative positions, by maintaining the availability of consistent reimbursement education and coding support, the client is able to address and resolve reimbursement issues quickly and prevent many more through a proactive presence in key offices.

Results
The goal of 80% of targeted providers injecting the product more than once within the first 90 days post-launch is achieved. After 1 year, provider retention and utilization exceeds expectations.