JDL Access accelerates commercialization for innovative medical technologies with patient access programs, reimbursement support, and payer advocacy.
We are driven by our passion to support and expand patient access to medical technologies
We are dedicated to collaboration, quality, and compliance
We strive to bridge the gap between commercialization and payer coverage
JDL Access provides end-to-end
patient and payer access services for medical technology companies
JDL Access was founded in 2021 by six industry veterans who continue to serve on the company’s Board.
We are led by Kim Norton, who has worked in medical device reimbursement for over 30 years, helping to establish coverage for many new technologies.
Helping medical technology companies enhance payer adoption with support lines, patient access programs, and market access services.
Facilitating case coverage by tailoring our services around your needs.
Accelerating payer adoption through deep payer policy expertise and networks.
This resource answers common questions about JDL Access’s services, the patient
access process, prior authorization, insurance appeals, and how we help medical
technology companies bridge the gap from commercialization to coverage. For
additional information, contact us at info@jdlaccess.com. Content developed by the JDL
Access team and Kim Norton, CEO, with 30+ years in medical device reimbursement
strategy and implementation.
JDL Access provides reimbursement support services for medical technology companies. Our mission is to bridge the gap between commercialization and coverage by designing tailored patient access programs, operating reimbursement support lines, and delivering payer access services. Through strategic use of patient appeals and expert payer advocacy, we enable patient access and accelerate payer adoption of innovative medical technologies.
JDL Access partners with medical technology manufacturers, particularly those launching new or emerging technologies where payer coverage, medical policy, or reimbursement pathways are not yet fully established. We work alongside manufacturers, their sales teams, provider offices, and patients to support individual case coverage and drive broad positive coverage at the payer medical policy level.
JDL Access was founded in 2021 by six industry veterans and is led by CEO Kim Norton, who has worked in medical device reimbursement for over 30 years, helping to establish coverage for many new technologies. Our team is composed of experienced patient advocates, analysts, and market access leaders.
JDL Access offers four core service lines: Patient Access Programs (customized case management and appeals support for new technologies), Reimbursement Support Lines (dedicated support for providers and patients navigating coverage, Payer Access Services (payer advocacy and medical policy development), and Insights consulting (helping companies to stand up or optimize internal patient access programs).
A patient access program is a structured support infrastructure designed to help patients access a medical technology when insurance coverage is unavailable or uncertain. It is essential when coverage varies by payer, medical policy does not yet exist, prior authorization denials are common, and/or provider adoption is limited.
A JDL Access patient access program includes benefits investigation and prior authorization support, and appeals handling (including multiple rounds of denials), including external appeals.
The goal is not permanent support. The goal is to enable early patient access, reduce provider hesitation, generate real-world access data, inform payer policy development, and transition toward normalized reimbursement. A patient access program is the bridge between innovation and real-world use. In our work with medtech manufacturers, the programs that succeed fastest are those that plan early for a patient access program.
Prior authorization (PA) is a process requiring insurers to formally review and approve coverage for a service or technology before it is provided. For established, standard-of-care treatments, prior authorization can create unnecessary delays. For innovative or emerging medical technologies, however, a prior authorization pathway serves a critical strategic function: it creates a formal mechanism through which coverage can be requested, denied, appealed, and ultimately established.
The information on this page reflects general reimbursement guidance. For case-specific support, JDL Access works directly with manufacturers and provider offices to navigate individual coverage situations.
A denial is not the final word. Patients have the right to appeal a coverage denial through a structured process. Most insurers are required to offer at least one internal appeal. If that appeal is unsuccessful, patients may be eligible to request an external review by an independent review organization. For Medicare beneficiaries, there is a multi-level appeals process that includes review by a Qualified Independent Contractor (QIC) and, if needed, a hearing before an Administrative Law Judge (ALJ). Under federal law, most insurers are required to offer at least one internal appeal.
An external review is a federally guaranteed process that allows patients to seek a third-party evaluation after their health insurer denies coverage for a medical service or treatment. It is conducted by an Independent Review Organization (IRO) – independent medical experts in the same specialty, unaffiliated with either the patient’s provider or insurer. Once the internal appeal process is exhausted, patients may request an external review. The final decision issued by the IRO is legally binding on the insurance company.
External reviews are especially important for novel technologies. Because insurers fund the process, IRO decisions place financial and operational pressure on payers to reevaluate their medical policies. Independent physician reviewers must examine clinical documentation against current medical standards, creating precedent and informing future coverage policy development. External review helps accelerate the integration of new, evidence-based treatments into coverage policies, benefiting all subsequent patients who need the same technology.
An Administrative Law Judge (ALJ) appeal is the third level of the Medicare appeals process. After a denied claim has been reviewed through reconsideration by a Qualified Independent Contractor (QIC), Medicare beneficiaries have the right to request a hearing before an ALJ at the Office of Medicare Hearings and Appeals (OMHA). This process applies to Medicare and Medicare Advantage plans. Unlike earlier review stages, an ALJ hearing allows claimants to present their case directly, submit new evidence, and question witnesses in a formal hearing setting.
After receiving an unfavorable reconsideration decision from the QIC, patients must submit a written request within 60 calendar days of receiving the denial. The request can be submitted online, by mail, or by fax using Form OMHA-100. If the claimant is being represented by another party, an Appointment of Representative (AOR) form is also required. Once the request is received, the hearing office confirms eligibility and issues a Notice of Hearing at least 20 days before the scheduled date, unless the claimant waives this requirement.
ALJ hearings are informal and typically last 30–60 minutes. They may be held in person, via video, or by telephone. All supporting documentation and witness information must be submitted no later than 5 business days before the hearing. The ALJ, claimant, representative (if any), and any witnesses — including vocational or medical experts — may participate. A determination is typically rendered within 30 days of the hearing. The ALJ’s decision is independent and legally binding.
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