GIRS has been working with a top insurance company since 2010 on behalf of our client to establish positive coverage for their Product. In February of 2014, after extensive payer follow up conducted by the GIRS team, the payer advised that the Biologic Product would be covered based on medical necessity even though it was listed as investigational in the payer’s medical policy. GIRS requested the policy staff to update the policy to reflect the coverage that was being implemented. This was accomplished by a continued effort to inform the payer about the inconsistency in the medical policy and the payer’s payment system and by sending the clinical information for review. When researching the payer’s medical policy later in the year, GIRS discovered that the Biologic Product is now has positive coverage effective April 2014. This was a huge win for our client. This particular insurance company has over several million covered lives.