Our Solutions
Our Genetic Test Module is a partnership with Concert Genetics.
The science of genetics has unlocked exciting advancements in health and medicine. Unfortunately, the complexity of genetic testing has also led to confusion and waste for health plans, providers, and members.
Genetic tests represent a disproportionate source of payment errors, appeals, and overturns. This is in part because the relationship between tests, codes, and criteria is unclear or rapidly changing.
+
Genetic Test Package Options
Our genetic test edits provide insight into the type of test represented by complex, multi-code claims and return precise payment instructions backed up by evidence and coding rules. The result is reduced medical costs, greater administrative efficiencies, low provider abrasion, and more consistent payment decisions for members and laboratories.
-
These edits enforce industry standard coding rules and clinical guidelines to prevent the most obvious and egregious errors, many of which go unchecked by standard code edits, plus additional standards derived from CPT® code book and AMA guidance. You issue a simple payment policy to require lab adherence to these coding standards, and the edits delivered through the CXT platform then deny claims with errors and violations.
-
These edits enforce clinical criteria from Concert Genetics’ machine-readable medical policy that includes unified set of content, combining machine-readable coverage criteria, a test catalog that is organized into a multi-level taxonomy, the most comprehensive test ID system, the Concert GTU™. Edits deny claims billed against policy.
Genetic Tests and Payment Accuracy: Charting the Course for Smarter Claims Management
Ready to maximize your savings and simplify your genetic test policy and edit management?
Complete our contact form and we’ll reach out to you! Or please email: sales@lyric.ai.