Testimonials - Page 2

<-- Testimonials - Page 1

  Coverage and Payment Services

1. Testimonial of Effective Reimbursement Support:

Sajini Thomas, President, GIRS, takes complete ownership of her projects and carries them out with a hands-on, detail-oriented approach, which ensures that she always has an in-depth understanding of the reimbursement environment for her clients’ products. At the same time, Sajini recognizes when it makes sense to obtain an outside perspective and does not hesitate to work with Panels of payers, regulatory experts, and reimbursement legal clinical experts when needed.

In the 10 months that we have worked with her, Sajini’s accomplishments have been impressive. The reimbursement issues surrounding high-cost biological products are complex, but Sajini has a solid understanding of these issues. By combining her on-the-job learning with her extensive past experience in reimbursement, Sajini has achieved a great deal in a very short period of time. Examples of her notable accomplishments include the following:

• A year ago, one of her clients received three product-specific HCPCS codes that have greatly facilitated Medicare appropriate coverage and payment for the products in the physician office and hospital outpatient settings. In my tenure as a consultant of a prestigious CRO, I have yet to encounter another biological, device, or pharmaceutical manufacturer that has received three HCPCS codes in a single quarter.
• Sajini has proactively sought and received the Centers for Medicare and Medicaid Services’ (CMS’s) and local payers’ approval for providers to use miscellaneous HCPCS codes to report her clients’ products when appropriate. The ability to use miscellaneous codes during an initial period when product-specific codes are not yet available is a crucial factor in providers’ uptake of new products.
• By implementing the payer advocacy plan that she launched this year, Sajini already has confirmed positive coverage for all Medicare Part A (hospital) contractors, most Medicare Part B (physician office) contractors, four key private insurers, and two state Medicaid programs.
• In addition to coordinating the submission of average sales price (ASP) data for her client’s biologics to CMS, Sajini regularly monitors and evaluates the subsequent payment rates to ensure the accuracy of CMS’s calculations, identify possible errors, and request corrections as necessary and appropriate.
• Sajini already is looking beyond the current year to ensure appropriate long-term reimbursement for her client’s products. Late last year, she submitted a request for a product-specific J-code for her client’s product that, if approved, would take effect in the near future. She also has begun the process of contacting CMS to advocate for continued separate hospital outpatient payment for her client’s products when their pass-through status expires.
• Sajini developed comprehensive billing guides and a reimbursement strategy report that will help providers and her client’s staff to better understand coverage, coding, and payment for their products. These billing guides provide appropriate payer verified coding and billing guidance for the potential codes for her client products.
• Sajini currently oversees a 300-call-per-month reimbursement hotline for her client’s product.

Equally as important as Sajini’s expertise and accomplishments is her ability to recognize the implications of reimbursement developments for providers. When she analyzes Medicare payment and policy changes, she immediately begins thinking about how to develop positive and accurate messages to communicate to her clients’ customers. Having worked in reimbursement consulting for several years, I cannot understate how important provider communication is; regardless of how favorable a reimbursement change may be for a company’s product, much of the potential benefit of the change could be lost if providers are not made aware of the change in an effective manner. Sajini understands the importance of provider communication—developing appropriate provider messages has been the focus of many of our collaborations—and never loses sight of this in her day-to-day work.

In addition to her professional strengths, Sajini possesses personal characteristics that make her a pleasure to work with.. Sajini also possesses strong communication skills. When we work together, she always makes clear what she is looking for and responds quickly to any follow-up questions, and the high-quality deliverables that she delivers to her clients reflect her strong writing skills. Reimbursement is an extremely challenging field that is characterized by constant changes, complex policies and regulations, and many hard deadlines, yet Sajini effectively balances her many responsibilities and is always level-headed, organized, and patient. Sajini is especially accommodating of her clients’ busy schedules and frequent travel, which they greatly appreciate.

Principal
Contract Research Organization (CRO)

2. Testimonial to Support Contribution to the Industry Upon Return to Consulting at The Lewin Group

Congratulations on your new position. You will certainly be missed…. Please know that you efforts made a difference not just for one modality, but for countless patients that it benefits. If you need anything at anytime, do not hesitate to drop me a line. The Lewin Group are a class act and I am sure that you will make a lasting impact.

Key Opinion Leader,
Professor of Surgery and Associate Dean
Rosslyn Franklyn University of Medicine and Science

<-- Back to Testimonials - Page 1

---

Testimonial/Reference letters are on file and will be provided to clients.

5100 Poplar Ave., Suite 2700 Memphis, TN 38137
(P) 1-901-322-6018 (F) 1-901-339-4840 / 1-901-752-0238
Contact Us

Additional Resources:
www.silverlon.com - wound care
Copyright © 2012 Global Integrated Reimbursement Services Inc. All Rights Reserved.