Today, Concert is delighted to announce a partnership with Lyric, formerly ClaimsXten Portfolio. Through this partnership, Concert’s genetic test payment accuracy capabilities will be made available through Lyric’s market-leading claim editing solution.

This solution addresses a costly challenge for health plans, and for the members they serve. Genetic testing claims are often complex and confusing, making them administratively difficult to process. Manual efforts to process these claims lead to inconsistent results that impact patient access and overall costs.

Automating accurate reimbursement for genetic tests is on the critical path to implementing cost-effective precision medicine in the U.S. healthcare system. Today’s announcement is an important step on this path, and as such, we are pleased to share it. The full announcement is below, and more information is available at the Lyric website.

 

Lyric to Add Genetic Testing Edits Module to Market-Leading Payment Accuracy Solutions
Partnership with Concert Genetics will leverage proprietary data and machine learning to maximize claims payment accuracy

June 7, 2023 – Lyric, formerly ClaimsXten Portfolio, has partnered with Concert Genetics (Concert), a leader in end-to-end genetic testing management, to deliver solutions to health plan payers who seek to maximize payment accuracy for genetic testing claims.

“Our partnership will combine machine learning models and proprietary market data,” Lyric CEO Rajeev Ronanki said. “By bringing together the power of our market-leading editing solution with Concert’s market-leading end-to-end genetic testing edits, we’re eliminating complexity in the ever-changing genetic testing space.”

Adding genetic testing content to Lyric’s payment accuracy offering will help to address a costly challenge for health plans and their members, as consistent payment decisions are almost impossible to achieve when frequently ordered genetic tests are billed using numerous codes in potentially thousands of combinations. The number of tests, scope of clinical applications, and associated clinical evidence are increasing, which can be challenging for healthcare providers and insurers. As a result, the experience of payers, providers, and patients is often fragmented and frustrating, potentially limiting access to clinically appropriate testing.

“This partnership is just one example of Lyric’s vision to simplify the business of care. We will continue to expand our own expertise and innovation, while also creating strategic partnerships with other industry leading subject matter experts to bring additional value to our customers, while reducing speed to market. The resulting solution will be a comprehensive playlist of options that will best meet our customers’ specialized needs,” Ronanki explained.

“Concert Genetics is building towards a vision in which information on genetic testing, including coverage and cost, is instantly available at the point-of-care to support informed clinical decisions and cost-effective access for patients,” said Rob Metcalf, CEO of Concert Genetics. “We are delighted to partner with Lyric, an organization that is aligned with this vision and brings to bear the technical infrastructure to connect information all the way through to reimbursement decisions.”

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About Lyric
Healthcare is complex. When codes, transactions, and small intricacies can lead to large issues and costly errors, transparency is more important than ever.

Lyric combines a flexible software rules engine with a comprehensive library of clinical content to help health plans address policy management needs and pay claims correctly the first time. The company’s advanced editing framework effectively applies health plan, governmental, and industry policy to a claim in near real time with interoperability designed and built to scale with a plan’s mix of products, network infrastructure, and growth. Lyric’s comprehensive product suite includes primary and secondary editing, content and policy management, and other analytics services and solutions.

If the healthcare tech system is a song, then clarity and seamlessness are its lyrics. We’re changing the tune of transparency by simplifying the business of care. Visit us at: www.lyrichealth.com to learn more about us.

About Concert Genetics
Concert Genetics is a software and managed services company that promotes health by providing the digital infrastructure for reliable and efficient management of genetic testing and precision medicine. Concert’s genetic testing management capabilities leverage a proprietary database of the U.S. clinical genetic testing market, market-leading expertise, and a technology platform that supports genetic test ordering, resulting, coding, coverage, and payment integrity.


Wed. June 7, 2023
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