See below for the recording and other resources.
1. Watch the webinar
2. Read Concert’s Guide to Medicare Advantage Coverage & Payment
Health plans, labs, clinicians and patients all struggle to accurately determine coverage and reimbursement of genetic tests and other laboratory services. With differing rules for Medicare Advantage (MA) and Original Medicare plans, this is especially true for Medicare beneficiaries. To clear up this confusion, Concert Genetics enlisted leading experts to provide definitive guidance on key questions, such as:
- How does coverage determination differ between MA and Original Medicare?
- What should plans do when criteria is not available in NCD/LCDs?
- What determines the LCD jurisdiction for lab services?
- What are the guidelines for using prior authorization in MA plans?
- Can MA plans establish their own billing, coding and payment policies?
- Can they negotiate rates that differ from the Clinical Lab Fee Schedule?
- Do these rules differ for in-network vs out-of-network lab providers?
To access the guide, click here.
3. Read the Definitive Guide to Genetic Testing
Access Part I: The Fundamentals here. This whitepaper provides a comprehensive look at the challenges in genetic testing and gives actionable recommendations to establish an end-to-end solution.
The 3 fundamental challenges that health plans face in genetic testing
Deep-dives in lab network contracting, UM, and payment integrity
Requirements for an effective solution, RFP checklist, and other valuable content
4. Review the Concert test catalog and reference medical policies
Create a free account here. Use the search bar to search the catalog of 175,000 tests including coding standards and GTU test IDs. To view Concert’s medical policies, select Reference Policies from the app grid menu at the top right. Using this tool you can read the policies, view references, and search for a specific test’s coverage criteria.
If you already have an account, you can simply click here to go directly to the tool.
5. Contact Concert Genetics
If you’d like to contact Concert to learn more, email connect[at]concertgenetics.com.