Clinical Guidance

Guidelines and Policies

InformedDNA’s solutions utilize the latest in clinical 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.

InformedGENOMICS™, our clinical guidance solution, centralizes and evaluates all the most up-to-date genomics policy guidance — making them available directly at your fingertips.

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 genomics expert, 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 make decisions based on consistent application of the most current clinical evidence in genomics. With InformedGENOMICS™, you receive:

  • Evidence-based coverage criteria, developed by genomics specialists
  • Comprehensive reference library with citations for 300+ categories of genetic conditions
  • Step-by-step decision aids for medical necessity decision-making
  • Curated CPT® codes by condition category, updated quarterly

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

Rigorous, provider-friendly guidelines reduce abrasion and drive adoption

New genetic tests enter the market every day, making it difficult to keep pace with change and determine which should be covered in your plan’s policies.

The guidelines must address many factors in the face of rapidly changing genomic science and a rapidly changing test landscape. This is further complicated by the cross-specialty relevance of genetic tests. Adopting a clinical specialty-based — rather than a gene- or test-based — approach to policy development represents a paradigm shift for most health plans. Traditional clinical utility frameworks are difficult to apply to genomics because they focus only on the amount and strength of research-based evidence — which is often limited in genomics.

To address the scarcity of outcomes evidence and clinical specialty-centric view needed, our clinical guidance evaluates the most current evidence in the context of clinically important factors. These include professional guidelines and expert opinion, clinical availability of comparable alternatives, personal utility, downstream costs, risk of overutilization, and risk of harm, all of which impact coverage assessment.

Once condition-specific guidelines are written, they are deployed in a systematic approach that ensures the policies evolve based on changing science and with real-world applications in mind.

Click the button below to learn about InformedGENOMICS™, our evidence-based genomics guidance subscription service for health plans:

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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