Rebecca Lanquist has over 12 years of experience developing and implementing reimbursement strategies for the U.S. market. She began her career working for the largest global prosthetic and custom orthotic manufacturer of computerized limbs and assistive walking devices, where she created a hotline service and an appeal consulting department for non-coded products. She also worked briefly as a Home Medical Equipment (HME) Billing Manager and helped build a growing billing operation for a multi-site company that specialized in custom wheelchairs and respiratory equipment. She cross-functionally collaborated on quality standards for complex ventilation and advocated with Minnesota Medicaid.

Recently, Rebecca was the primary reimbursement strategist for upstream product development at a large Danish medical device company. She launched over 36 product lines, advised on evidence development priorities, collaborated with Key Opinion Leaders (KOLs) to advocate for a new Medicare benefit category and navigated various Healthcare Common Procedure Coding Systems (HCPCS) challenges with great success. Since joining NAMSA in 2021, she has worked with Sponsors on coding applications and product re-design to optimize HCPCS code assignments. She specializes in durable medical equipment, prosthetics and orthotics, urology and bowel management, physical medical and rehabilitation, assistive devices, respiratory, wound, ostomy, supplies and remote patient monitoring.

CORE COMPETENCIES

• Reimbursement strategy and life-cycle product development, working cross-functionally with regulatory, research and development, medical affairs, marketing, sales and customer service
• Developing Medicare prosthetic story line for statutorily excluded product needing a new benefit assignment
• Advising on evidence development, KOL talk track and long-term Medicare strategy
• Creating market access commercialization plans for products that started with low stakeholder incentives and increased administrative burden
• Successful re-launching a product originally kicked out of its PDAC coding category
• Engaging Pricing, Data Analysis and Coding (PDAC) and Durable Medical Equipment Medicare Administrative Contractor (DME MAC) stakeholders
• Advising on interim business risk-mitigation strategies
• Providing guidance on clinical claims and evidence development needed for new coding categories and expanded coverage indications, analysis of private payer coverage needs and influence of third party publications and technology assessments
• Successful PDAC and HCPCS code applications
• Medicaid market access advocacy and coverage expansion. Integrated patient advocacy groups into reimbursement advocacy efforts
• Creating market access tools, such as billing guides, reimbursement kits, educational webinars, coverage maps and pricing analysis for products with new codes
• Managing reimbursement hotlines
  • Reviewing pre-authorization documentation
  • Creating targeted appeal arguments for audits and denials
  • Monitoring success rates
  • Answering coding questions

RECENT PROJECTS

• Created a new HCPCS code in the Neuromuscular Electrical Stimulation (NMES) category for a new indication
• Developed reimbursement kits for multiple stakeholders (Physician, DME Supplier and Patient)
• Reimbursement operations for a Patient Support and Reimbursement Program