Magellan partners with Concert Genetics to enhance genetic testing

Magellan Healthcare, a leading behavioral health and specialty segment of Magellan Health, Inc., has announced a new partnership with Concert Genetics, a managed services and software firm that offers the digital infrastructure and data, to manage genetic testing.

As per sources, by working together, the firms will offer an end-to-end, innovative solution that leverages utilization management processes of Magellan and claims integrations to provide improved quality, efficient management, and accurate payment in genetic testing.

Reportedly, the genetic testing landscape is tremendously evolving and changing. With nearly 175,000 orderable tests in the market with an overall yearly growth rate of 13%, the fast-expanding genetic testing industry coupled with its complexity is posing as a challenge to stakeholders throughout the healthcare system.

Additionally, variation in billing generates ambiguity and coding can lead to needless review costs. Not to mention, there are thousands of code variations and on an average, 6.9 codes are billed on every test. Complex coding in a fast-evolving field can lead to hardships with managing administration processes like claims editing.

According to reports, the efforts needed to manage genetic testing can seem endless due to the volume of the tests available. Even after accounting for 1-2% of medical expenditure, health plans can dedicate around 20% of medical policies and 15% of clinical reviews to this area.

The present medical policies for genetic testing can be hard to navigate, leading to inconsistent errors and application, generally falling behind the continuously evolving landscape of new evidence, tests, and guidelines.

Allegedly, the new solution will integrate a unique test ID system and an authoritative catalog of genetic tests with up-to-date test-specific coding standards, medical policies, real-time claim editing capabilities, and lab quality information delivered via Magellan’s proven delegated delivery model.

Source Credits: - https://www.businesswire.com/news/home/20220425005182/en/Magellan-Healthcare-Announces-New-Collaboration-with-Concert-Genetics-to-Improve-Genetic-Testing