CEO SUMMARY: With the ever-increasing number of genetic tests on the market, payers are understandably frustrated with genetic test claims that don’t clearly outline the medical need for a procedure or its clinical validity. One path forward is for labs to present data to justify a genetic test earlier in processing of the claim. GENETIC […]
Optum and Avalon Discuss Genetic Test Claims Review
One goal is to lessen prior authorization burdens through greater specificity about test validity, utility
- By Scott Wallask
- > From the Volume XXX, No. 9 - June 19, 2023 Issue
- Tags: Avalon, avalon healthcare solutions, clinically-indicated genetic test, CPT® codes, Cristi Radford MS, Current Procedural Terminology codes, executive war college, genetic test claim, Jason Bush PhD, lab intelligence, laboratory benefit management, LBM, MAC, Medicare Administrative Contractor, MolDx, molecular diagnostic services, Optum, Palmetto GBA, UHC, UnitedHealth Group, UnitedHealthcare, Z codes
