This is typically called a “MAC Audit”:

• Service Provider shall collaborate closely with COMPANY's internal team to research, identify and assess COMPANY's product(s) current coverage and policies on HCPCS codes for the Medicare MACs
• As it pertains to Medicare LCD's, RMBB shall identify coverage and any gaps, and address directly with each MAC
• Discover and ensure satisfactory fee schedules, places of service and provider types, such as, but not limited to Hospitals and Private office providers.
• This includes the creation of marketing collateral and training tools as needed for sales teams' and stakeholders for all identified coverage.
• MACs include: CGS, FCSO, NGS, Novitas, Noridian, Palmetto and WPS
• Services include, not limited to
  • reaching out to each MAC with company data and product pricing and information in order to establish MAC local reimbursement and update MUE limit, where applicable.
  • establish a tracking tool and make it shareable online to update progress.

Other Health Policy services include:

• Private/commercial payer policy outreach
• Medicaid research and outreach

• Provide communication via phone, text, and email.
• Provide relevant information regarding reimbursement rates, potential coding, and coverage questions as it pertains to company products in relevant site(s) of service
• Maintain communication logs through an executive summary.
• Produce weekly, monthly, and quarterly reporting as agreed upon.
• Participate in conference calls and/or answer questions separately
• Provide additional project work to support Company if it meets the general scope of the project and is agreed-upon in conversations or email communications between Company and Consultant.

• Specialty billing service direct to providers, focused on advanced wound care products.
• Also capable of providing full billing support (entire office).
• We take into account cost of goods and charges are based off the net reimbursement.
• We prefer to use the customers’ EMR and work closely with office to provide transparency.
• We also use in-house systems at the preference of the provider.