Concert Genetics Launches End-to-End Genetic Testing Management Program for Health Plans

By StartUp City | Tuesday, January 05, 2021

The solution comes as the volume of genetic testing keeps on rising and as biomarkers increasingly influence clinical decisions, cost, and quality of care.

Fremont, CA: Concert Genetics has unveiled the Concert Genetics Benefit Program, an end-to-end genetic testing management solution that allows health plans to provide members with access to clinically appropriate, high-quality genetic testing while improving payment integrity as well as reducing manual work.

This solution comes as the volume of genetic testing keeps on rising and as biomarkers increasingly influence clinical decisions, cost, and quality of care. The unique challenges of genetic testing – complex underlying technologies, rapidly innovating products, and highly variable codes – create confusion in coverage, inconsistent decisions, time-consuming reviews and frequent appeals.

"We saw an unsustainable rise in the administrative cost of managing genetic testing – for both plans and laboratories – so we built a solution to radically simplify and streamline these burdensome efforts by enabling greater clarity at every step in the process," stated Rob Metcalf, CEO of Concert Genetics.

"No other vendor can provide a solution that delivers quality, efficiency and transparency, while reducing manual effort," stated Metcalf. "With the Concert Genetics Benefit Program, health plans can provide members with access to high-value precision medicine services and improve the experience for everyone along the way."

Test Registry: Comprehensive registry of the U.S. clinical genetic testing market, which includes over 150,000 unique testing products and software that collects genetic laboratory quality information and offers an authoritative mapping of each laboratory test catalog to the corresponding health plan medical policy, billing codes, and rate.

Coding Engine: Product that systematically assigns a combination of codes or billing code or to each test in the registry, bringing transparency as well as consistency to an otherwise highly variable process.1,2

Medical Policies: A complete set of medical policies written by clinical genetics experts for ease and clarity of interpretation. Each test in the registry is linked to a medical policy through a comprehensive taxonomy.

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