Genetic Testing Program
Genetic Testing UM | Proven Expertise | Evidence-Based Medical Policy | Decision Support | Real-Time Preauthorization
With the genetic testing market growing by 10 -15 new tests DAILY, how can health plans stay current with a constantly-evolving genetic testing landscape and not risk quality in their GTUM? They can’t – not without the right help.
HealthHelp puts the power of an automated preauthorization decision support tool in the hands of your providers so they can confidently put their patients on the right path of quality care, in less time and with less cost to you.
Powered by InformedDNA, the nation’s leader in Genetic Benefits Management, there’s no other genomic solutions provider with the time-tested experience to cut through the clinical, coding, and financial complexities of genetic testing, resulting in decreased costs, improved provider satisfaction and quality member care.
HealthHelp’s genetic testing benefits management creates value for the provider, patient, and health plan with unique components including:
- Lower administrative burden and organizational complexity in-house
- Unlock cost savings and optimized genetic testing management, by leveraging reputable and trusted guidelines
- Receive efficient answers and supportive education to deliver quality care to patients
- Gain confidence in decision making through peer-to-peer reviews with expert specialists
- Receive high-quality care without time-consuming barriers
- Develop trust in their health plan through effective engagement
The InformedDNA Difference
InformedDNA is the nation’s largest and most experienced organization of full-time, lab-independent board-certified genomics specialists, providing coverage across all genetics specialties and across all states, with licensure in states that require it. InformedDNA isn’t lab-owned or lab-sponsored, so our counselors have no conflicts of interest in advising ordering providers and patients on the most appropriate use of genetic tests and results.
InformedDNA has a long history of collaborating with national and regional health plans to create and scale successful genomics benefits management (GBM) solutions for their plans, providers and members.
Genetic Testing Consult
HealthHelp ensures that members receive the most appropriate, evidence-based genetic tests to enhance their care.
Automated Decision Support
Providers submit genetic test. The request is reviewed against our evidence-based clinical guidelines, health plan medical policies, or both, for clinical appropriateness. If the request meets evidence-based and/or medical policy criteria, it is automatically approved.
Genetic Counselor Review
For complex cases, genetic counselors will review and provide decision support to help determine the next appropriate action and steer providers to the right test.
A HealthHelp physician reviews the request. After consultation with the requesting provider, the request will either be approved by the expert reviewer, or withdrawn/changed by the requesting provider.
Included for All Customers
Appeals Support: Despite best efforts to prevent denials, they may still occur – HealthHelp has you covered.
When you choose us as your GTUM benefits manager, you get a clinically accurate foundation of best-in-class medical policies and experience that boasts a .03% overturn rate of appeals.
Evidence-based guidelines and policies, updated continuously with new tests, ordering trends, claims, and UM data.