CPT code analysis, AMCP-format dossiers, MAC policy monitoring, and field team materials. The full reimbursement toolkit, in one workspace.
Trusted by over 200,000+ researchers
10,000+
CPT & HCPCS Codes Indexed
AMCP 4.1
Compliant Dossiers
12
MAC Jurisdictions Covered
100+
Payer Policies Monitored
Solution
Every code. Every policy. One workspace.
CPT Code Analysis
Compare CPT, HCPCS, and ICD-10 codes. Identify reimbursement rate differentials for your product.
AMCP Dossiers
Structured payer dossiers following the standard format for US formulary decisions.
Coverage Landscape
Payer policies, prior authorisation rules, and step therapy requirements across commercial and government plans.
Reimbursement Strategy
Coding strategy, coverage pathway selection, appeals guidance, and managed entry agreement planning.
Field Materials
Payer presentations, coding guides, objection handlers, and prior auth templates for managed markets teams.
Formulary Submissions
Formulary Submissions Ready-to-submit packages. Executive summary, clinical evidence, economic analyses, and supporting documentation.
Processes
How Coverage Gets Won
Every step built on the last, so the dossier never starts from scratch
Step 01
Assess
Full coverage landscape scan across Medicare, Medicaid, and commercial payers. Baseline what is covered, what is restricted, and where the real coding opportunity sits
Step 02
Analyse
CPT, HCPCS, and ICD-10 comparison with reimbursement rates pulled across MAC jurisdictions. Spot revenue leakage before it shows up in the next billing cycle.
Step 03
Build
AMCP-format dossier development with clinical and economic evidence pulled from the same source library your HEOR team uses. Templated once, reusable across payers.
Step 04
Equip
Field team materials built from the approved dossier. Coding guides, objection handlers, and payer-specific decks, all tied back to the source evidence behind every claim.
Step 05
Submit
Formulary submission packages prepared for P&T committees and payer coverage reviews. Every supporting document attached, every reference source-linked.
Deliverables
The things that sink coverage decisions, addressed directly
Every payer-facing output
AMCP-Format Dossiers
Full payer dossiers following AMCP Format 4.1. Executive summary, clinical and economic evidence, and value narrative.
