News
Concert Genetic Testing
Fecha: 04/03/24
Products: Ambetter and Wellcare By Allwell
Background
Advancements in the science of genetics and genomics have led to remarkable new options for medical professionals to diagnose, treat and prevent disease. As genetic testing has increasingly become the standard of care, our health plan is committed to providing the highest levels of access, quality and value for members in this exciting and dynamic segment of health care.
To achieve these goals, our health plan is asking for your support in the next phase of its genetic testing program. The goals of this phase are twofold -- advance the reliability of laboratory quality information and reduce variability in billing.
Beginning May 1, 2024, Managed Health Services (MHS) will expand the requirements for billing of genetic and molecular testing. In accordance with the Reimbursement Policy for Genetic/Molecular Test Coding Policy for the products Ambetter and Wellcare By Allwell, all providers billing for genetic and molecular testing services will be required to adhere to the coding recommendation in the Concert Genetics portal.
The portal can be accessed here: concertgenetics.com/join centene. The quality and billing integrity requirements in the reimbursement policy will be facilitated by Concert Genetics – our partner and 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.
What does this mean for our laboratory partners?
We are asking you, our laboratory partner, to do the following:
- Register with Concert Genetics
- Self-report on quality metrics in a common framework supplied by Concert
- Verify accuracy of test catalog and view coding recommendations and fee schedule
- Utilize Concert’s recommended codes when billing for genetic and molecular tests
Thank you for your support and continued partnership on providing our members with access to high-quality health care at an affordable price.