Precision Genetic Test Management
Next-generation solution to manage growth and costs of genetic testing.
Challenges
Genetic testing is exploding, and management is complex.
There are roughly 175,000 genetic tests available with 10 new tests hitting the market each day. There are only ~500 CPT codes available to identify all of those tests. This results in gaps in provider awareness and expertise; variations in coding, coverage, and reimbursement practices; a lack of rigorous clinical evidence and regulation; and wide variability in the quality and utility of precision tests along with the lack of genetic test specificity.
Our Solution
Innovative Genetic Test Management Necessary to Address Complexity
Precision Genetic Testing Management (PGTM) is the next evolution of Avalon’s genetic test management solution combining the lab testing expertise of Avalon with accurate claims data to produce a first-of-its-kind solution to manage genetic testing.
PGTM leverages the use of industry-standard DEX Z-Codes® mapped to evidence-based lab policies, enabling discrete test identification, test quality and validity. This supports automated prior authorization approvals. The result: improved and streamlined care with plan savings.
Avalon’s Lab Insights Solutions work together to arm you with critical lab-driven insights to accelerate your value-driven care success.
PGTM aligns Z-Codes® scientifically-backed policies,
and technology bringing clarity in decision-making and an improved genetic lab benefit experience for all stakeholders. Avalon estimates savings of $0.50 to $0.65 per member per month with our
PGTM solution.