Hotline Success Cases
Case 1:
Our hotline staff supported a low volume hotline for a novel product that did not have a unique HCPCS code at market launch. An unlisted code was covered by most payers for the product and an unlisted code had been assigned by the AMA for its application. Our hotline staff developed billing guides for the accounts, conducted benefit verifications to confirm payer recommended codes, and guide accounts to submit clean claims and to avoid unnecessary denials. We were successful in increasing sales by 30 percent, supporting the sale force, and our counselors were given high rankings in client satisfaction surveys.
The GIRS coverage and coding consultants currently are handling the coding and coverage strategies for this product. The synergy between the hotline staff and the coding and coverage consultants has lead to efficient and successful strategies to support our client's product.
Case 2:
Implemented a zero turnover, customized hotline for a novel product. Hotline consultants developed customized services to ensure support of key accounts. This resulted in 50 percent increase in sales within the first six months of product launch.
Case 3:
Implemented hotlines for a wide range of orthopedic products. It is a notable achievement that, to support customized implants for patients who have cancer, our hotline staff developed payer packages, and assisted accounts in submitting clean claims. Our payer coverage experts negotiated for coverage and appropriate payment of custom implants for cancer patients by providing clinical data, regulatory information, and information on the patient's condition.
References are available upon request.