Health plans now able to leverage latest evidence-based genomics decision support tool to increase member access to the highest quality care
InformedDNA®, the nation’s leading applied genomics solutions company, announced the launch of its new clinical guidance and decision support solution for genomics, InformedGENOMICS™. The on-demand SaaS product equips medical directors, clinical reviewers and medical coders at health plans with evidence-based genetic testing policy criteria and decision-support guidance developed by genetics and genomics experts to ensure health plans can process even the most complicated genetic testing case reviews in a fraction of the time it takes today.
“We understand that the most significant unmet need for medical directors in the genomics space is user-friendly access to the latest evidence supporting coverage of new genomics tests and treatments. InformedGENOMICS™ can help health plans stay up-to-date on the ever-changing body of genomics research within one resource to better inform policy development and coverage decisions. As the genomic testing landscape continues to evolve, health plans realize benefits for genomics must be managed differently than other specialities and are looking for resources such as InformedGENOMICS™ to provide the clinical guidance needed to develop effective policy,” said Sobha Pisharody, PhD, Chief Strategy and Product Officer at InformedDNA.
InformedGENOMICS™ solves the biggest health plan needs regarding genomics benefits management: Genomics policy guidance, regularly maintained to keep pace with the latest scientific advances and the rapid evolution of the molecular testing landscape. By providing clear, concise guidance directly from clinical genomics specialists, InformedGENOMICS™:
- Offers a single, reliable source for genetic testing policy criteria and coding, thus eliminating laborious research and excessive time spent by policy writers, claims analysts and contracting specialists;
- Eliminates confusion among medical reviewers related to the latest evidence and clinical approach to diagnosis and treatment for genetic conditions;
- Reduces appeal burden and provider abrasion by ensuring initial review decisions are based on consistent application of best practice medical policies and current evidence;
- Increases internal efficiencies and decreases effort to meet regulatory requirements associated with decision support, interrater reliability, and burden of proof for evidence-driven policies;
- Enables health plans to reduce unnecessary genetic testing and related downstream procedures and decreases risks and out-of-pocket expenses for health plan members.
“Evidence-based, easy-to-use medical policy is at the core of a strong utilization management (UM) program. With more than 167,000 genetic tests on the market and at least 10 tests or treatments being added daily, InformedGENOMICS™ is a valuable tool for existing utilization management programs that saves medical reviewers both time and effort associated with genetic case reviews and increases confidence, consistency and alignment amongst the benefits team,” said Pisharody.
InformedGENOMICS™ is a web-based subscription service giving health plans real-time access to:
- Up-to-date genomics coverage guidelines;
- Comprehensive literature reviews and references on hundreds of genetic conditions;
- Coverage decision workflows for clinical reviewers;
- Detailed molecular CPT® code insights.
“The field of genomics is complicated and as the largest applied genomics solutions company, our goal is to offer consistent access to best practice guidance in genetic testing which will enable health plans, patients, and providers to get the right care for the right patient at the right time,” said Pisharody.
To learn more about how to strengthen your genomics benefit management program, keep it up to date and reduce inherent risk, please fill out the form here or email us at healthplans@informeddna.com.
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