Welcome to PRIA Healthcare
“Every success story is a tale of constant adaption, revision and change.”
As PRIA Healthcare Management (PRIA) has evolved into the medical device industry’s most predominant partner in market access, we have embraced the ever-changing landscape of barriers to adoption put forth by insurers, both government and commercial. By offering a vast array of patient access and reimbursement related solutions, PRIA drives new technology adoption by providers in the care setting and payers in the coverage setting.
Our unique place in the market positions PRIA between patients, providers, medical device manufacturers and payors. Our flexibility allows each client we service the ability to customize an approach to meet their individual needs. PRIA prides itself on understanding the current climate of healthcare and the unique challenges each manufacturer, physician and patient face in the process of gaining coverage.
By tactically addressing the needs of our clients, PRIA is able to deliver unmatched success in patient access to prescribed care. Strategically, our process of selecting only the most respected and experienced strategic reimbursement partners, as well as employing some of the most tenured professionals in the industry internally, we have effectively embraced the adaption, revision, and change necessary to navigate the success of the next life changing treatment in the market.
We look forward to the opportunity to be your Helping Hand in Healthcare!
Michael T. Simon
Founder & CEO
Market Adoption Higher Success in Authorizations
Targeted Payer Efforts Increased Product Usage
Coding, COVERAGE, Reimbursement
Since 2012, PRIA has met the needs of our clients and their changing reimbursement and coverage landscapes by focusing on the tactical approach to driving negative payer policy change, driven via case-by-case appeals of denied care. Through this process we have touched the lives of hundreds of thousands of patients, attaining life-changing authorizations for medically necessary treatment, making PRIA the leader in Patient Access Appeals. Understanding that without COVERAGE of a technology or procedure, coding and reimbursement are generally unnecessary.
PRIA Can Help
Effective management from concept through commercialization of your product, as well as success in the market is why so many choose PRIA. Our attention to detail and focus on customer satisfaction is just the beginning.
By partnering with several nationally respected strategic reimbursement firms, PRIA can identify the ideal partner to guide strategic behavior based on expertise in the customer specialty. Secondly, PRIA’s staff of industry professionals ensures that each customer is afforded the most current expert advice while offering technologically modern and customized solutions for our clients.
How We Do It
PRIA has partnered with the world’s largest CRM provider to offer HIPAA safe online access, data collection, process transparency, and customized reporting, available to all of our customers.
The information made available to our clients as a result of the platform we have built has assisted in many critical decision making processes amongst executives. The ability to define, track, and report on patients, studies, and outcomes has shaped how major policy decisions are developed and presented to payors.
"PRIA, the recent addition of our office to the portal has been great. We can now better inform our patients of their status in the appeals process which they very much appreciate. Thank you for all of your efforts in helping so many of our patients to get approved, it is very much appreciated."
-MD From Kansas
Customized Patient Access Programs that deliver serious results.
Insurers have continuously built barriers targeting medical device adoption in an effort to reduce cost and curve utilization. Deeming products or procedures experimental or investigational and not medically necessary is becoming a norm. Our role at PRIA is to overcome these barriers from product inception through to market acceptance with positive coverage.
IS YOUR PRODUCT OR PROCEDURE EXPERIENCING COVERAGE OR REIMBURSEMENT RELATED BARRIERS TO SUCCESS?
WE’VE GOT YOU COVERED!
PRIA’s industry leading approach to IDENTIFYING, TARGETING, and OVERCOMING insurance related barriers is unmatched. Our custom Patient Access Client Portals allow us to:
- Aggregate Custom Data
- Report on Data in HIPPA safe and HIPPA restricted settings
- Provide transparency into the process for client sales representatives through executive management, physician office customers, and more.
PRIA’s Patient Access Programs have the ability to support products and procedures in all stages of the process with commercial insurers as well as all government payors and supplement plans. Some of the services we provide include, Verification of Benefits, Predetermination and Pre-Authorizations, Peer-to-Peers, Level One and Two Appeals Submissions, Hearings, Claims Denials, External Review Submissions, and more.
I received a call a few minutes ago from the insurance company stating that they have approved the procedure, and will be sending out a letter very soon. It was indeed welcome news, and I just wanted to really thank you for all of the time and effort that you put into this for me. It really means a lot to know that your company is willing to go the extra mile on behalf of others.
Patient from North Carolina
The PRIA Difference
From the moment we engage with our clients, we begin the process of establishing an understanding of their current market position. Our Staff takes the time to listen to the needs of the customer and identify the strategic and tactical requirements of instituting positive payor policy change. We immediately foster a partnership with the internal team at the organization we are supporting and align our goals for future patient access.
By integrating technology into our approach, PRIA further drives engagement amongst all stakeholders. Our platform’s ease of use, HIPAA safe case submission ability, collection of instrumental data, transparency of process, data analytics, custom field development and reporting, and easy to access mobile and desktop applications make our technology platform the industry’s best. Pair this with the most experienced patient advocates/case managers at PRIA and success is the only option.
PRIA, Your Helping Hand in Healthcare!
"It is with great pleasure that I recommend PRIA Healthcare for both market access strategic planning efforts and patient access initiatives. PRIA has worked collaboratively with the Torax Medical team and taken a very broken patient access program and converted it into an exceptionally successful program with clearly defined metrics to drive strategic decisions within. The patient access portal has helped to improve our engagement with providers, patients and insurers alike. We would not be where we are today without the expertise of PRIA!"
Janet Fike, Director of Reimbursement and Market Access
Passionate. Respected. Innovative. Attentive.
PRIA’s reputation of providing our clients with the industry’s most successful patient access programs is the core of our business. Our in-house staff of 20+ advocates/case managers with over 50 years of healthcare experience specialize in reimbursement, strategic initiatives, coding and billing, insurance claims, appeals, and so much more. Our dedication to customer service and quality from our passionate staff make PRIA the most respected organization in the industry. Our innovation and attention to each patient we serve make us who we are!
Contact PRIA Healthcare Services
How to find PRIA:
We appreciate your interest. We will respond to any inquiries as quickly as possible. Thank you and we look forward to working with you!
By Phone or Fax
M - F 8:30 - 8:00 PM EST
32 City Hall Avenue
Torrington, CT 06790
We are happy to answer any questions. Email us at: