GIRS was requested to investigate a denied Benefit Verification (BV) for a certain Biologic and then to develop Medicaid coverage strategies to obtain positive coverage. The payer was a state-wide medical assistance program. With research, GIRS was able to find out the private insurance company that managed the state medical assistance program. GIRS was able to establish and build a rapport with the private insurance company staff to find out who would be reviewing the clinical information to establish positive coverage for the client’s Product. GIRS was informed in writing by the payer of the current coverage for the Biologic and the requirements for the medical policy review including the documentation requirements for the coverage request. In addition, the payer provided a step-by-step review process and timeline. The client and GIRS are now preparing the payer dossier to request coverage for the Biologic. GIRS was able to open the door to obtaining coverage from a payer that is difficult to access because of our extensive professional experience and competent payer communication skills.