ReimbursementOS
Available nowCurrent reimbursement intelligence for every stage of a medical device product.
ReimbursementOS helps medical device manufacturers keep reimbursement information current, prepare source-supported feasibility reports for new products and create annual Reimbursement & Coding Guide drafts with one button.
Built for: Medical device manufacturers, reimbursement and market access teams, and certified coding reviewers
Runs at reimbursementos.qevatrix.com
About this app
Keep reimbursement intelligence current, assess new-product feasibility and create the next annual Reimbursement & Coding Guide draft with one button.
ReimbursementOS is the manufacturer workspace for product-level reimbursement planning and maintenance. It brings verified product facts, source-linked coding and coverage research, feasibility reports, approved baseline guides and annual updates into one versioned record.
What you can do
- Maintain a source-linked reimbursement record for each medical device product line
- Generate a versioned reimbursement feasibility report for a new product
- Create an annual Reimbursement & Coding Guide draft from the approved baseline with one button
- Review coding, coverage and available payment context with source and effective dates
- Route every draft through source verification and certified-coder review before delivery
Problems it solves
- New-product reimbursement feasibility assembled manually across disconnected sources
- Annual coding guides rebuilt from scratch instead of a controlled baseline
- Coding, coverage and payment changes discovered without a clear product-line impact record
Who it is for
- Medical device manufacturers
- Reimbursement and market access teams
- Product strategy and commercialization leaders
- Certified coding reviewers
Works with
Where authorized, verified device facts can be matched to ReimbursementOS product lines. Conflicts remain visible for review and are never silently overwritten.
Capabilities
What ReimbursementOS does
Every module writes to the same controlled record set, so nothing has to be exported, re-keyed or reconciled.
Current reimbursement intelligence
Monitor source-linked coding, coverage, payment and policy information by product line, with retrieval dates, effective dates, alerts and unresolved verification gaps kept visible.
New-product feasibility reports
Generate a versioned draft covering the likely coding pathway, coverage landscape, evidence gaps, business risks, next actions and sources for a new product. Qualified reviewers confirm every conclusion.
Annual Reimbursement & Coding Guides
Create the next annual guide draft with one button from the approved baseline and current information, with a change log and source-verification gaps shown before certified-coder review.
Product-line record
Keep verified product facts, imported baseline guides, feasibility reports, original source files, annual editions and activity history together for each product line.
Code, coverage and payment context
Review device, procedure and grouping codes, official coverage documents and available Medicare payment context by care setting, without turning the workspace into a claims system.
Controlled review and history
Drafts, sources, status changes and approvals are versioned and audited. A guide cannot be published or delivered until its exact version passes the required certified-coder and content-rights gates.
Regulatory foundation
Standards it is built against
- CMS HCPCS quarterly updates
- CMS OPPS and IPPS final rules
- Medicare Physician Fee Schedule
- NCCI PTP edits and MUE limits
- Medicare Coverage Database (NCDs and LCDs)
Qevatrix Intelligence
Where AI helps — and where it stops
Qevatrix Intelligence prepares draft feasibility reports and annual guide updates from supplied facts and permitted sources. It does not invent codes or coverage conclusions, and every deliverable remains subject to source verification and certified-coder review.
Pricing
ReimbursementOS plans
Coding and Medicare payment reference for device teams. Pricing is quoted per organization based on users and device categories.
Organization
Coding, reimbursement and market access teams
Quoted per organization
annual agreement
Named users, agreed at onboarding
AI change summaries included with fair-use protections
- Device code lookup across CPT, HCPCS, ICD-10-PCS, ICD-10-CM, MS-DRG and APC
- Medicare payment amounts by care setting with source and effective date
- Pass-through, NTAP and device-intensive flags, NCCI edits and MUE limits
- Daily monitoring of official CMS sources with watch-list alerts
- Saved lookups and estimates with notes
AI included with fair-use protections. Allowances are per tier and abuse controls apply; we contact you before any limit affects your work.
For reference only. Verify with official CMS sources and payer contracts before billing. Prices in USD, excluding applicable taxes.
Value
The commercial case
What it replaces
A quarterly scramble through CMS files, spreadsheets of codes with no provenance, and denials discovered after the fact.
- One search instead of several CMS downloads per device
- Every number carrying its source and effective date
- Changes flagged the day they publish, on the codes you watch
Questions
ReimbursementOS pricing FAQ
- Do you reproduce official CPT descriptions?
- No. Code numbers are stored with Qevatrix-authored plain-language summaries; official AMA descriptors require a licence and are never reproduced.
- Which device categories are covered?
- Spinal implants first. The data model is category-agnostic, so cardiac, joints and neurostimulation are added without restructuring.
- Can we cancel?
- Subscriptions run for the committed term. Annual plans do not auto-escalate mid-term, and you can choose not to renew with 30 days' notice before the renewal date. Month-to-month plans, where offered, can be cancelled at the end of any billing month.
- How much does annual billing save?
- Annual commitment is the recommended option and is priced roughly 15-20% below the equivalent month-to-month rate. The exact saving for each plan is shown on its card when you switch the billing toggle.
- Is onboarding included?
- Standard onboarding — tenant setup, configuration walkthrough, administrator training and the standard validation documentation — is included on self-service tiers. Assisted implementation, data migration and executed validation are optional paid services, quoted before you buy. Enterprise implementation is scoped in your agreement.
- Are there mandatory implementation fees?
- No. Nothing is invoiced that is not on your order form. If your deployment needs assisted implementation or executed IQ/OQ, we quote it up front as an optional service rather than adding it later.
- How are users counted?
- Pricing is based on edit and power users — people who create, review, approve or sign records. Read-only, training-only and basic users are generous by design, because a quality or regulatory system only works when everyone can see it.
- Is AI included?
- AI included with fair-use protections. Allowances are per tier and abuse controls apply; we contact you before any limit affects your work.
- Do we pay for updates?
- No. Product updates, new capability within your tier and regulatory content updates are part of the subscription. Version history and validation impact notes are published with each release.
- What support is included?
- All plans include email support from people who have worked in regulated environments. Professional and above include prioritised response targets; Enterprise agreements can define named contacts and response commitments.
- What does Enterprise add?
- Multi-site and unlimited scale, SAML/OIDC and SCIM-ready provisioning, dedicated validation support, custom retention and data residency, API and integration work, and priority onboarding. Enterprise is always a quoted annual agreement.
- Can we upgrade later?
- Yes. Applications share one tenant and one identity, so moving up a tier or activating another Qevatrix application makes your existing records available immediately — there is no migration and no re-keying. Upgrades are pro-rated.
- Can we get our data out?
- Always. Records, revisions, signature manifests and the audit trail export to open formats (CSV and PDF packages), and Enterprise agreements can add scheduled or API-based extraction.