Clinical Guidance

Guidelines and Policies

The InformedDNA Genomic Benefits Management (GBM) solution utilizes the latest in evidence, bioethics, and public health expertise to help health plans offer provider-friendly genomic coverage policies and guidelines. Our condition-specific approach to genomic coverage policy reduces complexities and provider abrasion, all while decreasing inappropriate genetic testing and its related spend.

Our holistic GBM solution centralizes and evaluates all of the most up-to-date research and evidence in the context of additional relevant factors, bridging the gap between the evidence that health plans require and the evidence available in the unique field of genomics.

Reduce Complexity and Costs

Our clinical guidelines for appropriate use of genomic testing improves patient care while decreasing inappropriate costs. 

Decrease Provider Abrasion

Our guidelines, written by expert clinicians, for clinicians, enable plans to consolidate policies and incorporate real-world clinical care practices, leading to decreased provider abrasion and increased adoption.

Optimize Appropriate Use

Expert curation and quarterly review of clinical guidelines and changing genetic testing markets ensures coverage of currently available tests to stay ahead of new, yet medically unnecessary testing.                 

Let’s talk about your needs!

Thank you for considering InformedDNA as your applied genomics solutions company. Please let us know how we can help meet your needs.

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InformedDNA provides the broad and deep genetic counseling expertise that we need, while making the process easy and convenient so their services are well received by our providers and patients. Because of our partnership, we’re able to offer timely access to genetics experts, who provide the level of care, recommendation and follow up that is truly desired by our constituents.

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Reduce Prior Authorization Complexities

Avoid unnecessary denials by guiding providers to alternative test options and labs when appropriate. Our holistic GBM approach enables us to provide:

  • Guidelines developed through our rigorous process that integrates evidence-based review with clinical expertise
  • A fully automated genetic testing prior authorization solution with our channel partner, with ability to get point of care approvals     
  • Expert opinion reviews, as needed, by genetic analysts who based on their experiences as clinicians can synthesize case-specific data and evidence-based criteria into determination recommendations

Reduce Genetic Test Complexity and Spend

Balancing national guidelines with condition-specific criteria leads to improved payer policies and better health outcomes for patients. InformedDNA supports your guideline development with:

  • The largest full-time staff of lab-independent genetic specialists in the nation 
  • Proprietary up to date library of evidence reviews encompassing thousands of detailed summaries of available tests and potential genetic diagnoses for policy and review support
  • Clinical experience and deep subject-matter expertise
  • A clear understanding of the challenges associated with using genetics in healthcare—and the most appropriate, safe, effective solutions

Ease of Use Leads to Increased Compliance

New tests enter the market every day, making it difficult to keep pace with change. InformedDNA’s holistic GBM approach organizes criteria by clinical condition instead of by test, enabling us to address 100% of available genetic tests by focusing on the relatively smaller number of clinical indications.

Determining clinical appropriateness is complex, because genetic testing incorporates unique variables such as multiple genes per condition, varied testing methodologies, and diverse laboratory offerings. In addition to evaluating the medical necessity of testing for the indication, the test itself must also be evaluated for appropriateness. 

A condition-specific approach supports providers, too, who commonly say they do not know which tests to order or how to interpret the results. Our criteria follow clinical logic, addressing policy through the lens of clinical indication leading to natural groupings of alike tests.

Our Latest Thinking on Genomics

Your Trusted Partner in Applying Genomic Science

InformedDNA is the nation’s first telehealth genomics services company. Our real-world clinical guidance, cost management and patient navigation solutions are built upon the most current genomics insights and are designed to optimize clinical decisions across the care delivery spectrum.

We have helped manage the health benefits of more than 100 million covered lives and have navigated hundreds of thousands of people to the right treatments or clinical trials.

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