Learn More About Payer Advisory Program:

RJ Health’s Payer Advisory Program:

A Direct Link to Payers to Deliver Pricing, Coding & Clinical Updates for Your Brand

The complexity of the medical billing and coding in U.S. healthcare system leads to an excessive amount of errors from both HCPs and payers that result in a loss of medical dollars and extreme frustration in the healthcare system. Manufacturers need to reach payer decision-makers and clearly communicate clinical and billing information related to their drugs, based on trusted third-party sources – and avoid denials.

RJ Health provides an advisory service where manufacturers can deliver custom messaging to over 100 health plan clients, representing roughly 130 million lives. Connecting to this vast community of payers minimizes the common denials that many medical benefit drugs face when updates are introduced. Concise communication around medical drug intelligence provides correct reimbursement, coding and pricing information to the key decision-makers that you need to influence.

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Solving market access challenges is all we do.

Meet the Experts Highlight Videos:

Big Pharma Case Study: Communicating Your Pricing Update to Payers:

Emerging Pharma Case Study: Simplifying Pricing Submissions:

Best Practices Around Pricing and Coding Updates During Your Brand’s Lifecycle:

View Full Recordings

Client Use Case #1: Inform Key Payer Decision-Makers Around Pricing & Coding Updates

How can I keep payers informed about my pricing & coding updates?
  • RJ Health provides an advisory service where manufacturers can deliver custom messaging to over 100 health plan clients, representing roughly 130 million lives
  • Concise communication around medical drug intelligence provides correct reimbursement, coding and pricing information to the key decision-makers that you need to influence
  • Key information included: HCPCS/CPT code, Indications for use, Related ICD-10-CM codes, Administration codes, Pricing information

Client Use Case #2: Reduce Denials Due to Unclear Messaging

How can I reduce denials around my product based on the lack of clear messaging around product pricing and coding updates?
  • Manufacturers need to reach payer decision-makers and clearly communicate clinical and billing information related to their drugs, based on trusted third-party sources – and avoid denials
  • Reduce denials through clear messaging on product pricing, coding or reimbursement updates
  • Ensure timely and appropriate reimbursement for HCPCS and CPT coded products

Client Use Case #3: Manage Competitive Pricing Trends

How can I manage competitive pricing trends and how this intersects with market access?
  • Connecting to this vast community of payers minimizes the common denials that many medical benefit drugs face when updates are introduced
  • Deploy direct communications to the payers that matter, especially when in a highly active competitive landscape where competitors are introducing pricing updates frequently
Use Pharma Advisory to:
  • Reduce denials through clear messaging on product pricing, coding or reimbursement updates
  • Manage competitive pricing trends and how this intersects with product access in your landscape
  • Engage the payers that will help move the needle in specific geographies and trigger direct communication
  • Reach payer decision-makers that represent over 100 orgs and 130 million lives, including 80% of BCBS plans
  • Ensure timely and appropriate reimbursement for HCPCS and CPT coded products

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