Reimbursement & Policy Insights

Maximize patient access at every stage of the product lifecycle.

Clients count on our reimbursement and health policy expertise to develop strategies that adapt to the changing payer environment and ensure appropriate patient access. Whether it’s designing provider tools that break down complex billing and coding, or educating provider offices on how to proactively position for legislative and regulatory updates, Xcenda’s RPI team has the knowledge, experience, and client service skills to create and implement effective strategies for success. 

Patient and Provider Access Strategy

Build a comprehensive reimbursement and launch strategy

The right combination of patient assistance programs, reimbursement, and copay support programs requires a delicate balance of maximizing access while supporting strategic brand imperatives. Our experts are ready to explore the dynamics of access and reimbursement across any site of care, from the physician office and hospital to long-term care and within patients’ homes. Partner with us to design the optimal support solution based on your patient population’s specific needs.

Reimbursement and Policy Analytics

Inform your patient access strategies with evidence-based insights

Our reimbursement and policy analytics team provides clients with a deeper understanding of health policy implications. Using detailed data analyses, including market assessment, payment system modeling, budget scoring, and payer and formulary analyses, our team delivers evidence-based insights and recommendations that help increase patient access. 
Datasheets on a table

Payer Segmentation

Know where to focus payer communications for optimized access

Coverage can vary greatly — not just from payer to payer, but also from state to state. We complete necessary payer research to identify specific dynamics, such as utilization management requirements and payer behavioral characteristics. By identifying the current reimbursement environment for individual products and mapping out dynamics across a therapeutic area over time, our experts formulate and execute on plans to help you focus resources for key results. 

Avoid the J-code black hole  

In today’s increasingly tight margins, no one can afford imperfect coding. The repercussions of incorrect coding, denied claims, and reimbursement delays can have an unacceptable impact on speed to therapy. Let our team of certified coders help you understand current product codes, evaluate different coding options, and provide support with new code applications to ultimately maximize patient access.
Learn about our deep approach to coding
Compendia Strategy

Develop a compendia strategy to guide coverage decisions

Understanding appropriate patient access to needed treatments for non-labeled indications requires a strategic approach to compendia. Turn to our experts in compendia strategy to develop materials that help influence and guide coverage decisions affecting prescribing behaviors and patient access.

Our approach includes:

  • Compendia Benchmarking Analysis
  • Benchmarking Analysis
  • Gap Analysis
  • Submission Package
  • Surveillance
  • Payer Utilization and Trends Analysis

Develop the knowledge - and share it

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