Thought Leadership

Our leading subject matter experts share their insightful analysis and points of view to help you stay abreast of industry trends

Medical Billing and Coding

New HCPCS Codes for Generics: What Payers and Manufacturers Should Know to Ensure Accurate Reimbursement

As if medical billing and coding wasn’t challenging enough, 2023 brings a new layer of complexity: the establishment of unique HCPCS codes for generic drugs. Specifically, the new codes affect generics approved under the FDA’s 505(b)(2) new drug application (NDA) and biologics license application (BLA) pathways. In its Q3 2022

How Medical Billing and Coding Can Impact Patient Access

There are many moving parts when it comes to helping ensure that patients can get access to the therapies they need, but the role of medical billing and coding isn’t always top of mind. To be fair, medical billing seems to grow more complex by the day, and keeping abreast

Payers Are Using NDC Mandates, but Are They Doing Enough?

The drug development pipeline is dominated by specialty therapies, more and more of which are being managed under the medical benefit. Therefore, payers will increasingly need to manage those drugs themselves, given that the PBMs they’d normally rely on don’t process these sorts of claims. As a result, payers are

Navigating HCPCS Coding Changes to Prevent Medical Reimbursement Challenges

When it comes to medical reimbursement, there are several challenges that both payers and providers face in today’s rapidly changing regulatory environment. With new drugs and generics entering the market at breakneck speed and supply chain issues continuing to plague manufacturers, it can be difficult for stakeholders to keep up