PRIA Healthcare Management, LLC
PRIA Healthcare is dedicated to accelerating the adoption of healthcare innovation by providing tailored reimbursement strategies, market access solutions, and comprehensive support throughout the product lifecycle. Their mission is to make breakthrough medical technologies accessible to patients who need them most, through expert guidance, data-driven programs, and strategic partnerships. They foster a culture of collaboration, innovation, and advocacy, aiming to make healthcare more accessible, equitable, and efficient.
Industries
Nr. of Employees
medium (51-250)
PRIA Healthcare Management, LLC
Torrington, Connecticut, United States, North America
Products
Patient access portal (CRM-integrated, HIPAA-compliant)
A hosted platform that centralizes enrollment, case submission, documentation of medical necessity, and provides real-time analytics for patient access programs.
Patient access portal (CRM-integrated, HIPAA-compliant)
A hosted platform that centralizes enrollment, case submission, documentation of medical necessity, and provides real-time analytics for patient access programs.
Services
Strategic reimbursement and HEOR consulting
Consulting to develop coding, coverage, and payment strategies combined with health economics and outcomes research to support payer coverage decisions.
Patient access program development and managed services
Design and management of patient access programs including launch planning, SOPs, communications, training, and ongoing operations to secure patient access to procedures and devices.
Patient access portal (software platform)
Encrypted, HIPAA-compliant portal for patient enrollment, guided case submission, provider visibility, and program analytics; available in configurable deployments.
Prior authorization, benefits verification and appeals operations
Operational processing of prior authorizations, benefits verification, appeals management, external reviews, and post-service claims support delivered by experienced operational teams.
Payer engagement and contracting advisory
Consulting and engagement services for negotiations with commercial payers, Medicare, and Medicaid MCOs, including fee-schedule strategy and stakeholder engagement plans.
Reimbursement hotline and payer support
Staffed hotline and payer-facing support channels to answer coding, coverage, and case-specific reimbursement questions for field teams and providers.
Strategic reimbursement and HEOR consulting
Consulting to develop coding, coverage, and payment strategies combined with health economics and outcomes research to support payer coverage decisions.
Patient access program development and managed services
Design and management of patient access programs including launch planning, SOPs, communications, training, and ongoing operations to secure patient access to procedures and devices.
Patient access portal (software platform)
Encrypted, HIPAA-compliant portal for patient enrollment, guided case submission, provider visibility, and program analytics; available in configurable deployments.
Prior authorization, benefits verification and appeals operations
Operational processing of prior authorizations, benefits verification, appeals management, external reviews, and post-service claims support delivered by experienced operational teams.
Payer engagement and contracting advisory
Consulting and engagement services for negotiations with commercial payers, Medicare, and Medicaid MCOs, including fee-schedule strategy and stakeholder engagement plans.
Reimbursement hotline and payer support
Staffed hotline and payer-facing support channels to answer coding, coverage, and case-specific reimbursement questions for field teams and providers.
Expertise Areas
- Reimbursement strategy and coding
- Market access and payer engagement
- Patient access program design and operations
- Health economics and outcomes research (HEOR)
Key Technologies
- HIPAA-compliant patient portals
- CRM-integrated patient access platforms
- Real-time analytics dashboards
- Provider and payer segmentation analytics