Lab Insights Solutions
AvalonSelect Genetic Network
A curated, preferred genetic lab network coupled with consulting services that simplifies genetic test management while decreasing costs.
Industry Challenge:
There are over 175,000 clinical genetic tests currently available, and the rate of innovation is staggering; ~10 new genetic tests hit the market each day. The overall market is projected to double by 2025. Ensuring adequate access to quality testing while appropriately controlling the costs of these procedures has become increasingly complex and resource intensive.
Our Solution:
The AvalonSelect Genetic Network can help health plans simplify genetic test management, decrease costs and administrative burden while improving the quality of genetic tests provided to members.
~10+% savings on overall genetic test spend with contracted preferred network &
negotiated fee schedule
AvalonSelect Genetic Network Overview
Avalon’s genetic network is a select group of preferred genetic labs coupled with robust consultative services that complement a health plan’s existing routine lab network. Health plans can continue to leverage their current lab relationships while outsourcing the management of genetic testing, pricing, compliance enforcement, test quality assessment, new test evaluation, and contracting to Avalon.
- Curated Genetic Lab Network & Preferred Provider Program: The AvalonSelect Genetic Network includes a nationwide preferred network with contracting support and a negotiated fee schedule. Preferred lab providers are invited to participate in our network based on quality performance.
- Provider Gold Card: Select providers that demonstrate consistent policy adherence and high performance based on Avalon’s historical prior authorization approval rates are eligible for gold card status. The reduction or elimination of prior authorization requirements reduces administrative burden for the health plan and lab, improves member and provider experience, and ensures quality enforcement.
- Credentialing Support & Emerging Technology Review Service: Avalon provides credentialing support based on current industry standards (CLIA, CAP, COLA). In addition, our comprehensive, evidence-based new test evaluation process for LDTs leverages Avalon’s experts and an independent clinical advisory board. Our emerging technology review service includes clinical utility and analytical and clinical validity which guides coverage decisions reflected in Avalon’s lab policies. This consultative service supports lab innovation while removing the administrative burden for the health plan.
- Genetic Network Strategy & Provider Support: Leverage Avalon’s deep expertise and provider resources to effectively manage a genetic network on behalf of health plans. Our consultative approach helps our clients develop a cost-effective, member-friendly lab network strategy that promotes appropriate utilization and directs members to high-quality labs.
Why should genetic labs participate in Avalon’s preferred genetic network?
The AvalonSelect Genetic Network will simplify processes and expedite reimbursement for participating preferred labs.
The Value of the AvalonSelect Genetic Network Solution to Health Plans
Avalon’s extensive lab contracting experience along with our evidence-based new test evaluation service coupled with our preferred genetic network, drive access to quality tests while simplifying the complexity and costs of genetic testing.
- Increased plan savings
- Simplified administration
- Improved provider experience and greater consistency in reimbursement expectations
- Reduced potential for FWA
- Collaboration with your internal network team
To learn how the AvalonSelect Genetic Network and consultative services drives cost savings, reduces administrative burden, and simplifies genetic test management complexity contact us.