Our Mission
To provide current, accurate, relevant, coding, coverage, payment and health care strategy and payment policy information for our clients’ specific needs, creating and transforming complex payment systems into clear and manageable business opportunities.
Denise A. Merlino, CPC, MBA, CNMT is a nationally recognized coding expert. She has expertise in E/M, telemedicine, care management, nuclear medicine, medical imaging, critical care, pulmonary, sleep, psychiatry, geriatrics, drug and radiopharmaceutical reimbursement, hospital and physician office payment policy.
Ms. Merlino has more than 40 years of experience with clinical, administration and health policy issues in hospitals and physician group practices. She is a nuclear medicine technologist and a certified professional coder with hospital and physician group practice healthcare network experience for a variety of medical specialties. She also has extensive administrative experience in finance, strategic planning and project management
Denise A. Merlino, President
Denise Merlino specializes in developing relationships, education, and other healthcare reimbursement strategies and tactics for medical professional organizations in a variety of healthcare and technology fields. She advises clients on coding, coverage, payment and health policy issues.
Ms. Merlino has spent 18 years in hospital and physician office, financial, billing, coding, coverage, payment, strategic planning and project management. Ms. Merlino has spent close to four (4) years as an employee in various positions from Professional Relations, Domestic Commercial Development and Payer Marketing for a large pharmaceutical company. Since 2003, when she launched Merlino Healthcare Consulting, and in 2024 opened Merlino Healthcare & RE consulting. She has provided reimbursement guidance for many professional societies, pharmaceutical companies, imaging companies and biotechnology in a variety of capacities from education, to development and implementation of new coding structures as well as new and innovative payment policy initiatives. In a variety of capacities, she has drafted and submitted Healthcare Common Procedure Code System (HCPCS) code applications for temporary and permanent HCPCS Level II codes for diagnostic and therapeutic supplies, drugs (including radiopharmaceuticals, and biologicals) obtaining many new and revised HCPCS level II codes over the past 20 years.
She has been an invited speaker on the topics of Coding, Coverage and Payment, the AMA CPT and RUC process, APC and other general Reimbursement topics to a variety of audiences. Ms. Merlino is a certified Nuclear Medicine Technologist, Fellow of the Society of Nuclear Medicine and Molecular Imaging Technologist Section and Certified Professional Coder, receiving an M.B.A with a concentration of Healthcare Administration from Western New England College.