What We Do Advisory Services Commercial Reimbursement Operations

Commercial Reimbursement Operations

Winning coverage on paper is only the start. Once your device is on the market, your patients, their physicians, and your own sales team all need help turning that coverage into approved claims and completed procedures. Avania manages the day-to-day coding and reimbursement work that keeps patients, providers, and commercial teams moving forward. We also equip your field organization with clear, practical resources for navigating coverage conversations. One partner for the full go-to-market journey, delivered through our CoachLine support lines.

Key Differentiators:

25+ years of hands-on medical coding, billing, and coverage operations experience
CoachLine patient, provider, and sales support on a Salesforce-powered, HIPAA-compliant platform
Trusted by both emerging device companies and top 10 MedTech manufacturers

Global market access

Navigating the Complexities

Understanding Your Challenges

The road from an approved code to a paid claim is rarely smooth. After launch, MedTech manufacturers run into operational barriers that slow adoption, including:

Sales reps sitting across from a customer with coding and coverage questions they cannot answer
Physicians and facilities unsure how to code and bill for a new product or procedure
Prior authorization and documentation rules that shift by payor and by plan
Denied claims and appeals that stall procedures and frustrate busy practices

What’s at Stake

When coverage support breaks down after launch, the cost is real. Procedures get delayed, patients walk away from treatment, and physicians lose confidence in a new technology. Weak reimbursement operations can quietly cap the adoption of even the strongest device. A dedicated operational partner keeps your patients moving through the coverage process.

Is Now the Right Time for Reimbursement Operations Support?

Reimbursement support is not something to stand up only when problems appear. The right time to build it is before or alongside your commercial launch, so your sales team and your patients have somewhere to turn from the very first account. Avania scales with you at every stage of your product’s life on the market.

Launch and Early Commercial Stage Support

For manufacturers in their first years on the market, we stand up a complete reimbursement support program without the cost of building one in house. Our certified coders handle benefit verification, prior authorization support, coding guidance, and coverage questions from day one, and back your reps with the coding guides new accounts need to make a decision to adopt the new technology. You get a proven operation running on the CoachLine platform.

Established and Scaling Portfolio Support

For established manufacturers and top 10 MedTech organizations, we add capacity and specialized coding depth to programs that have outgrown internal resources. We manage complex appeals, and multi product coverage support across therapeutic areas. Salesforce Health Cloud brings every case together in one place, and monthly dashboard reporting shows your team how access is performing across the portfolio.

Why Avania: Your Operational Partner in Coverage and Access

Our Experts

The Minds Behind Your Success

Behind every CoachLine program is a team of certified coders and reimbursement specialists who have spent their careers helping patients, and providers get to “Yes” on coverage. They provide support , case by case, so no one is left alone with a reimbursement question. Our specialists hold AAPC coding certifications across CPC, COC, and ICD-10-CM, with device experience that runs from implants and minimally invasive surgery to electrophysiology, neurovascular, robotics, and remote patient monitoring. Their combined experience gives clients direct access to specialists who understand both the technical requirements of coding and the practical realities facing patients, practices, payors, and commercial teams.

Speak with our Experts

Director, Reimbursement Operations

Jennifer Varela

25+ years in medical coding, coverage and reimbursement operations
AAPC Certified Professional Coder and Certified Outpatient Coder
ICD-10-CM certified, with a background in patient advocacy

Senior Reimbursement Leader

Samara Lynn

10+ years of hands-on coding and reimbursement support
AAPC Certified Professional Coder, ICD-10-CM certified
Specialty depth in spine and ENT device reimbursement relations

Continuum of Expertise

Reimbursement operations do not stand alone. Avania connects your coverage support to the regulatory, clinical, and market access work that comes before it, so nothing is lost in the handoff. When our market access team secures your codes and coverage strategy, our reimbursement operations team puts that strategy into daily practice in the field. You get one partner across the full commercial journey, and you can start with us at any point that fits your needs.

MedTech Focus, Purpose-Built

Unlike generalist support vendors, Avania was built for medical technology. Device coding and coverage requires unique expertise and where other reimbursement vendors stop at a denied claim, we carry coverage all the way through to exhaust the appeals processes. Our specialists build every CoachLine program around how your device is actually used, reimbursed, and introduced into clinical practice.

Comprehensive Reimbursement Operations Capabilities

Every CoachLine engagement is built around one idea. A single coding and reimbursement support line that serves three audiences at once, your patients, the providers and facilities who treat them, and your own field and sales team. Here is what that support covers:

Detailed Service Offerings

Commercial Coding and Reimbursement Support Line:

For your sales team, physicians, and facilities. Our certified coders answer CPT, ICD-10, DRG, and coverage questions on new and existing products, so a rep can walk into a customer with clear guidance on how the product is coded, covered, and paid. Our coding and reimbursement support lines remove the sales rep from this conversation as our team provides coding guidance assets and reimbursement specialist support of these discussions. We also support new product hospital acquisition forms, field reimbursement questions, and the day to day coding assistance to the site that uses it.

CPT, HCPCS, and DRG coding guidance for new and existing products
Field and sales team support for new product adoption and hospital acquisition forms
Coverage and payment answers for physicians and facilities

Patient Access Support Line:

For patients navigating coverage on higher-cost procedures and devices. We help patients and their physicians move from a prescribed treatment to an approved claim. We provide:

Benefit verification and coverage discovery
Prior authorization support and documentation
Denied claim review and appeals, pre-service and post-service
Patient authorized coaching or full BAA managed support
Coverage pathway guidance

Clinical Trial Coding and Reimbursement Support Line:

For clinical sites running a trial, we guide investigators and site staff on how to code and bill for the investigational product and routine care services. We also deliver standard-of-care coverage determinations across Medicare regions, so your sites bill correctly from the first patient.

CPT coding and billing guidance for investigational products
Standard-of-care coverage determination across Medicare regions
Site support from study start through last patient

Sales and Market Engagement Assets:

Understanding reimbursement is a necessary component of market access. Alongside the support lines, we build the assets your commercial team carries into the field. Validated coding guidance documents, pre-authorization and appeals letter templates that turn coverage complexities into a clear story for the payor that a physician, or a patient can act on. This is where Avania goes beyond reimbursement into complete go-to-market support.

Validation of existing coding
Pre-authorization and appeals letter templates by payor type
Coding and reimbursement one pagers and coding guidance assets
Updates to existing coding guidance materials as codes, payment and coverage change

Powered by Salesforce Health Cloud:

Every CoachLine program runs on a Salesforce-powered, HIPAA-compliant platform, with a dedicated toll-free number and email intake so patients, providers, and reps always know where to turn. Cases are tracked from first contact to resolution, and reporting scales with your program, from exported case summaries to a reimbursement dashboard updated for your team each month.

Doctor using calculator and work on laptop computer

Therapeutic Focus

Coverage rules and documentation standards vary widely from one clinical area to the next. Our team brings coding and operations experience across the therapeutic areas our manufacturers serve most:

Cardiovascular and Electrophysiology – Ablation catheters, implantable devices, and structural heart procedures.
Neurology and Neurovascular – Neuro implants, neurovascular devices, and neuromodulation therapies.
Orthopedics and Musculoskeletal – Implants, bone transport, and surgical reconstruction.
Craniomaxillofacial and ENT – Facial reconstruction, sinus, and airway devices.
Gastroenterology – Endoscopic and minimally invasive digestive devices.
General and Minimally Invasive Surgery – Access instruments and surgical platforms.

our approach

Avania’s Integrated Approach to Reimbursement Operations

Avania reimbursement operations extends the capabilities of your commercial team, combining transparency, communication, and shared purpose in every engagement. Our reimbursement operations pair certified coding expertise with the technology of Salesforce Health Cloud and the sales and market assets that turn coverage into adoption and access.

Whether you need a complete CoachLine program built from the ground up or added capacity for a specific product line, we adapt to your evolving needs, filling gaps, scaling with your growth, and holding to high standards of quality, compliance, and operational excellence across every case.

Ready to Strengthen Your

Reimbursement Operations?

Your patients deserve a clear path to the treatments you have worked to bring to market. Partner with Avania to keep coverage moving with the certified expertise, operational discipline, and the go-to-market support expected from MedTech’s trusted champion.

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