State of the Genetic Testing Marketplace–Getting Paid for All Your Lab’s Genetic Test Claims: What’s Changing, What’s Not, and What’s Working Best

 Webinar Held Thursday, March 25

Now a streaming webinar!

Getting paid for genetic test claims continues to be the single biggest challenge for all clinical laboratories and anatomic pathology groups. In response to the substantial surge in the numbers of new genetic tests—many of which cost thousands of dollars per test—payers are placing tougher restrictions how they accept and pay for genetic test claims.

In this webinar, State of the Genetic Testing Marketplace–Getting Paid for All Your Lab’s Genetic Test Claims: What’s Changing, What’s Not, and What’s Working Best, an expert panel from Concert Genetics, XIFIN, and Bruce Quinn Associates, LLC shares the following three approaches savvy genetic testing executives can take to significantly increase net collected revenue and reduce denials:

1. Obtaining a successful coverage decision for your lab’s genetic test by understanding how to meet a payer’s coverage criteria

2. Working with individual health plans so that your genetic testing lab becomes an in-network provider

3. Submitting a higher proportion of “clean” genetic test claims that the payer reimburses on first submission because your laboratory created appropriate workflows with referring physicians to both meet any prior-authorization requirement and to get the proper documentation from the physician that supports medical necessity and other payer requirements

Every clinical laboratory and genetic test company can use these three approaches to significantly increase net collected revenue and reduce denials, but only if the coding, billing, and collections team understands the current state of genetic testing in the United States and how that is driving payer actions to manage utilization of genetic test claims.

Now a streaming webinar!

Tune into this webinar to:

• Learn why payers must now deal with more than 1,000 new genetic testing products launching every month and how that complicates claims processing
• Understand how the variation in CPT coding by different genetic testing labs complicates claims processing by payers
• Explore the challenges and opportunities to help payers apply their medical policies to genetic test claims
• Understand why “benefit investigation” is already a huge factor as consumers seek the lab with the cheapest genetic test price before they agree to be tested
• Master the art of working with prior-authorization programs and know why having documents prior to authorization still does not mean the payer will reimburse for that genetic test claim
• Compare different tactics when payers audit genetic test claims and learn the right way to respond to documentation for medical necessity
• Assess Medicare’s policy changes at the national level for genetic tests
• Know the core elements of the Medicare MolDx program that governs genetic test claims across 28 states
• Distinguish how the federal government’s Operation Double Helix cracked down on billions of dollars of fraudulent use of genetic tests
• Use the Operation Double Helix court documents as the road map to identify the genetic tests and CPT codes that federal prosecutors use to guide their enforcement of the Anti-Kickback Statute, the Stark Law, and EKRA.

Who should attend?

• Clinical laboratory directors
• Laboratory managers
• Clinical pathologists
• Laboratory technicians
• Anyone involved in genetic testing coding, billing, and collections

Genetic testing is the fastest-growing sector of clinical laboratory medicine. This webinar will help you and your lab team better align coding, billing and collection steps in ways that directly generate more paid claims for genetic test claims, thus bringing in more revenue. Of equal importance, your lab will be better at obtaining prior-authorization for a larger proportion of genetic test requests, while having the physician documents necessary to support prior-authorization and any payer audits that come later.

Now a streaming webinar!

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 THE DARK REPORT WEBINAR AT A GLANCE

DATE:                       Held Thursday, March 25
TIME:                        1 PM EDT; Noon CDT; 10 AM PDT
PLACE:                     Your computer and/or speakerphone
COST:                       $195
TO STREAM:            Click here or call 512-264-7103.