Our company recently enlisted the services of Sajini Thomas of Global Integrated Reimbursement Services, Inc. to obtain Federal recognition of our product for a specific HCPCS code. Ms. Thomas’ thorough understanding of the Medicare Pricing, Data Analysis and Coding (PDAC) rules and processes and her efforts to submit a competent application, without a doubt, helped to secure the appropriate code for our technology. Ms. Thomas’ attention to detail and rigorous research skills were invaluable in attaining our goal. We highly recommend utilizing Ms. Thomas’ services in your efforts to acquire Federal recognition for your products.

Chief Executive Officer, Medical Technology Company

Over the last year, I have had the pleasure of working with Sajini Thomas, President, GIRS. She has been excellent in assisting my company with the regulatory issues of the USA government offices of SADMERC/PDAC due to her knowledge of Medicare regulations and her willingness to work with payers to provide them all the information that they require to make coding and coverage decision. She was able to assist me in acquiring Medicare Reimbursement Codes for my product line.

Her work is quite thorough and we would recommend her consulting services to everyone. Sajini truly understands the complexity of the government offices and also understands what is involved to complete projects. She follows through on all projects in a timely manner with the appropriate offices to make sure the project(s) are getting the attention needed to reach the desired goal.

Her consulting expands further into legislative activities. In working with her, she has provided professional guidelines on key legislative issues to provide direction with various marketing avenues that stay in compliance with the laws and rules set forth by our government offices. Some of the key areas we have utilized Sajini were on legislation, changes effecting healthcare entities such as: nursing homes, homecare, hospice, hospitals, etc…. We greatly appreciate her knowledge of the legislative activities. She has assisted us in developing different marketing programs that have improved patient access to our products and also to remain in compliance.

We are thankful that we have had the opportunity to work with Sajini and look forward to many more rewarding years ahead.

Director of Marketing, Medical Device Company

GIRS Payer Advocacy Compass^® support lead to increased market access for our flagship product, improved patient access, provider satisfaction and reduction of confusion, and eventually we were acquired by a large company.

Due to the excellent and thorough Landscape Assessment that lead to Payer Advocacy and clinical outcomes strategies, our company was able to obtain Medicare coverage for a biologic in one year after experiencing non – coverage for eight years.  Our company was acquired by a large company due to the reimbursement support we received from GIRS for our flagship product. We are continuing to work with the GIRS Payer Advocacy team in other payer markets and for additional products.

Reimbursement Director, Biologics Company

I am writing this letter in support of Ms. Sajini Thomas and her team. I have been working with Ms. Thomas and her team during the last several months in our goal to obtain reimbursement codes for our Tissue product line. Ms. Thomas has been a pleasure to work with regarding these issues. We have worked together in numerous projects and meetings, including but not limited to: meeting with various insurers and payers, the drafting of policy language, as well as meetings with CMS to obtain Medicare coverage for the product line. Her work is performed on a timely fashion with a quality that is second to none.

She is also extremely professional and has the ability to achieve positive outcomes in the most difficult of situations, due to her extensive experience with payers, her willingness to work with the payers to meet their requirements and regulations.

Sajini has been a pleasure to work with on a daily basis. Because of her strong work ethic, surgeons are able to provide patients a new treatment option in treating their very difficult problems.

Key Opinion Leader/Principal Investigator

This note is to serve as a letter of thanks as well as a letter of suggestion. In the short time I have had the fortunate opportunity to work with the GIRS run Helpline for our product, I have found that the reimbursement counselor assigned to our product has been a tremendous help in facilitating and providing our almost skeptical medical surgeons and their clinics with the necessary and appropriate reimbursement information regarding our product. As sales representatives, we are not reimbursement experts qualified to provide appropriate reimbursement information.

If possible, one immediate suggestion I propose is to open that realm of product support to our other products, which so often times alludes us based on reimbursement questions that we do not have the expertise to address ourselves. It is my understanding that our competitor’s products which addresses identical indications, is gaining ground on the reimbursement front because of a recent clinical study that was published. The GIRS run reimbursement Helpline, if expanded to support our other product, would play a most valuable role to provide accurate reimbursement guidance safely if this product was possibly added to the already successful product Helpline.

Sales Representative, Biologics Company

I worked with GIRS because they were the only firm that answered the phone immediately and gave me an original proposal that showed that they had knowledge of the DME reimbursement field.  The Reimbursement Landscape Assessment for our physical therapy device helped us understand the key reason for the lack of reimbursement for our codes-our regulatory strategies.  This helped us to plan future Company strategies to support the device.

CEO, Medical Device Company

We got five proposals for a Reimbursement Landscape Assessment. We decided to work with GIRS because the pricing was just in the middle and the work that was proposed was extensive work and in line with the work proposed by other such top firms that were sent RFPs.  We also had knowledgeable discussions before signing on that gave us confidence to do this extensive work. The Reimbursement Landscape Assessment that was conducted by the GIRS Value Discovery Landscape Assessment^® was a thorough, strategic, and well written. The guidance was well laid out so that we could prioritize it and implement it based on our budgetary allowance. We highly recommend conducting such assessments ahead of time and to work with GIRS for reliable results.

VP, Global Biologic Firm

Sajini Thomas, President, GIRS and her staff provided excellent reimbursement consulting services on a recent contract we awarded to her company to conduct a Reimbursement Assessment for one of our client’s biologic Product. Her following contributions to a very complex engagement are worth mentioning:

Sajini and her staff developed a comprehensive and detailed strategic reimbursement analysis report for our French client that described the U.S health care system (Medicare, Medicaid, and private insurers) and the medical treatment policies of payers in the various settings of care.

Based on a thorough analysis of payer policies and competing products, Sajini provided very creative and innovative strategies that met payer regulations/policies/requirements to hasten product uptake in the U.S. market. Sajini and her team also networked with key clinicians and decision makers in the industry and laid the foundation for potential alliances to enable commercialization of the product.

It was a great pleasure working with Sajini and her company and I remain impressed by the quality of her work, thoroughness of research, follow up diligence, organizational skills, and client interaction skills. Sajini Thomas and her company of experts are an exceptionally valuable asset to medical technology companies. I wish her continued success as she moves ahead with her the leadership of her company.

President, Management and Marketing Consulting Company

I am the owner of a reimbursement consulting firm in business for over 19 years and have worked with Sajini Thomas and her reimbursement experts on a number of projects. She is intelligent, thorough, and her quality of work is excellent. She always responds to requests in a timely manner and completes projects within budget and deadlines. My particular business utilizes independent contractors exclusively and her company is one of the best. She would certainly be an asset to anyone working in health care reimbursement, economics, policy, technology, or any number of related areas. She also has good knowledge of reimbursement compliance issues and educates her clients on the importance of working with a good reimbursement legal counsel and regulatory experts.

President, Reimbursement Consulting Firm

I am writing this letter in support of Ms. Sajini Thomas and her team. I have been working with Ms. Thomas and her team during the last several months in our goal to obtain reimbursement codes for our Tissue product line. Ms. Thomas has been a pleasure to work with regarding these issues. We have worked together in numerous projects and meetings, including but not limited to: meeting with various insurers and payers, the drafting of policy language, as well as meetings with CMS to obtain Medicare coverage for the product line. Her work is performed on a timely fashion with a quality that is second to none.

She is also extremely professional and has the ability to achieve positive outcomes in the most difficult of situations, due to her extensive experience with payers, her willingness to work with the payers to meet their requirements and regulations.

Sajini has been a pleasure to work with on a daily basis. Because of her strong work ethic, surgeons are able to provide patients a new treatment option in treating their very difficult problems.

Anonymous

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)