Genetic Test Claims Guide for Health Plans

Practical ways to reduce unnecessary genetic claims costs

Thirty percent of genetic testing claims are coded inaccurately—and this can lead to higher-than-necessary genetic claims costs. Yet most payers aren’t aware they are paying more for genetic testing than they should.

How does this happen? Typically, overbilling, or overpayment, can occur when:

  • Payers’ claims systems can’t identify the actual test performed;
  • Codes, or unit counts of codes, are inappropriate to bill for the specific test;
  • Non-covered tests are billed and paid;
  • Allowed amounts vary 10-20X for the same test.

The result: significant expense that could be avoided with the right genetic claims editing approach in place.

Learn four practical strategies for reducing unnecessary genetic test claims payments – download our new guide paper: “Eliminating the Hidden Costs of Genetic Testing Claims.”

We hope you’ll find these best practices insightful. Questions on overcoming genetic test claims payment challenges? Contact us to continue the conversation – just use the form below.