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When a payer has verified and established a less than positive coverage determination and the existing policy does not adequately provide coverage or reimbursement, or if the policy appears to be more restrictive than the majority of payer plans, a Payer Advocacy effort may be appropriate to establish, broaden or change the existing payer policy.
The Palomino Group works with the payer by providing evidence-based documentation and commentary, along with any available information that could support a coverage and reimbursement policy recommendation that is more appropriate.
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