It starts with deciphering what tests are actually being performed. Concert Genetics is uniquely positioned to decode claims because we have developed and organized the most comprehensive catalogue of genetic tests on the market.

Using sophisticated analytic methods, we run claims through an algorithm that matches each with a test (or testing category) in our database. Then, experts manually review a subset to ensure accuracy.

In matching claims back to the specific product ordered, we answer questions like:

  • Which genetic tests are driving spend?

  • What categories of testing are growing the fastest?

  • What prices are being paid for certain tests?

Concert Genetics has performed this analysis on claims representing over 100 million members for health plans of various sizes, identifying hundreds of millions of dollars in potential savings.

Using these capabilities, we deliver value in three functional areas: Medical Policy, Payment Integrity and Laboratory Contracting.