Model Process
WHAT IS THE PROCESS FOR MODEL DEVELOPMENT?
The process for developing our model starts by identifying:
- CPT Appropriate CPT/HCPCS Codes to report your device/procedure.
- CPT CPT/HCPCS Codes that are ancillary to your device/procedure (downstream revenue).
- Financial projections by sites of service for your device/procedure (inpatient, outpatient, ASC, physician office,and DME).
- Current Medicare and Private Payer reimbursement rates for your device/procedure (by site of service).
- Coding Convention (CCI edits, multiple procedure rules, bundling of services) that applies to your device/procedure.
- Payer coverage policy for your device/procedure and apply payment filters to compensate for coverage or non-coverage decisions by specific payers.
Legal and regulatory boundaries (ensure compliance regulations are met) for reporting your device’s potential financial impact.
HOW DOES MODEL WORK?
Fully automated financial model that requires input of sales and hospital financial data into a single Assumptions Worksheet. Single worksheet input.
- Custom tailored to your specific device(s)/procedure and your individual hospital’s or stakeholder’s facility and payer market.
- Displays multiple financial worksheets, or only those you want to share, during meetings with decision makers. Make it simple or present a fully detailed model.
- Automatic and real-time creation of an Executive Summary of financial metrics from Excel file in a PPT presentation with visual graphics.
- A tool to capture and hold the attention of your audience.
- Interactive model that allows for real-time customization during a face-to-face meeting with decision makers.