Approval Is the Beginning. Access Is the Work.
Coding, coverage, and payment requirements shape how quickly patients start therapy.
We help manufacturers plan for each one, from launch readiness through the full product lifecycle.
Specialists Who Know Coverage
With backgrounds in medical, policy, and payer systems, our specialists identify coverage gaps, communicate your product’s clinical and economic value to payers, and keep your team informed as coverage decisions develop.
92%+ first-pass prior authorization approval rates
For buy and bill therapies, our virtual Field Reimbursement Managers (vFRMs) provide non-sales education to site business office, revenue cycle, and procurement teams. As your product is introduced, they explain payer policies and publicly available coding and billing resources.
A Consultative Approach, Led by Your Product's Value
Our teams combine certified coding professionals, licensed clinicians, and leaders with direct payer, provider, and hospital revenue cycle experience.
Launch readiness: We build your coverage and reimbursement strategy before launch, so your product begins with a clear path to payment.
Coverage and reimbursement strategy: Whether your therapy is covered under the pharmacy, medical, or DME benefit, we build the strategy that supports coverage and helps keep it in place.
Payer and stakeholder education: We equip your field and policy teams with the clinical and economic evidence they need at every stage of commercialization.
Denial and appeal navigation: Guidance through corrected claims, reprocessing requests, and appeals within applicable deadlines, with clear reporting on status at every stage.
Support That Evolves With Your Product
From launch through established use, we adapt reimbursement support as your product reaches new sites, payers, and billing models. Our specialists address site-of-care access barriers alongside your teams and existing patient support programs.
Engage us for one product or broader operations, with market access, revenue cycle management (RCM), and virtual FRM services available individually or together.
Success Stories
Virtual FRM Support Helps a New Drug Launch Reach Profitability Within Two Quarters
How PRO-spectus virtual field reimbursement managers supported a phased launch across HOPD, inpatient, ASC, and provider group settings to reach profitability.
Read Article
Patient Access, Built Around Every Patient and Every Case
What does market access include?
Market access at PRO-spectus covers launch readiness, coverage and reimbursement strategy, payer and stakeholder education, and denial and appeal navigation. Our team helps biopharma manufacturers plan for coding, coverage, and payment from launch through the product lifecycle.
When should we start working with a market access partner?
Many manufacturers begin before launch, so coverage and reimbursement strategy is in place on day one. We also support established products as they reach new sites, payers, and billing models.
Which benefit types do you support?
We support therapies covered under the pharmacy, medical, or DME benefit, and we build the strategy around the pathway your product follows.
Do you support buy and bill therapies?
Yes. Our virtual FRMs provide education to the business office, revenue cycle, and procurement teams at each site, covering payer policies and publicly available coding and billing resources.
Is the vFRM role a sales role?
No. vFRMs are a non-sales, education-focused resource that does not promote products or discuss clinical use.
Can you help with denials and appeals?
Yes. We provide guidance through corrected claims, reprocessing requests, and appeals within applicable deadlines, and we report on status at every stage.
Can we engage you for one product or one service?
Yes. You can engage us for a single product or broader operations, and market access, RCM, and virtual FRM services can be engaged independently or together.
