Definitive Guide to Genetic Testing for Health Plans (Part I)

The Fundamentals:
What makes genetic testing so challenging to manage, and what can health plans do about it

This whitepaper is Part I of a 2-part series. Part II, which provides an in-depth look at an end-to-end solution for genetic testing management, is available here.

The science of genetics has unlocked exciting advancements in health and life sciences. Unfortunately, the complexity of genetic testing creates confusion, burden, and waste for health insurers. Traditional solutions have failed to adequately address these challenges.

This whitepaper provides a comprehensive look at the problem and delivers actionable enterprise and department-level recommendations to put in place an end-to-end solution.

Content includes:

  • 3 fundamental challenges that prevent health plans from effectively managing genetic testing
  • Department-level deep-dives in:

Medical Policy
Medical Management & UM
Claims Operations
Payment Integrity
Network Contracting
Genetics / Genomics
Finance
Medical Economics
Member Services & Members

  • Requirements for an effective solution with actionable recommendations at the enterprise and department levels
  • Comprehensive challenge-solution grid
  • RFP Checklist for evaluating potential vendors
  • Other valuable resources including program scope outlines and reference medical policies

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