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Genetic Testing

Experience the AltuMED Difference

With over 20 years of specializing in genetic billing services, AltuMED brings unparalleled expertise to meet today’s challenges. Our dedicated genetic billing team knows the CPT codes, modifiers, and payer coverage policies inside and out. We combine that knowledge with cutting-edge technologies and tailored workflows to optimize billing accuracy and efficiency.

The result? First-pass claims payment rates average over 90% for our molecular billing clients.

Expertise in Overcoming Billing Challenges

Genetic and genomic testing offer vital clinical insights for diagnosis, treatment, & disease prevention. Billing and reimbursement for these advanced tests pose significant challenges for many providers. Complex codes, payer policy shifts, and denials hinder the lab's genetic testing.

AltuMED tackles these challenges with over 20 years of genetic testing & billing expertise. Our billing specialists assist healthcare organizations in navigating reimbursement for genetic services efficiently.

Our Laboratory Billing Expertise Spans

Clinical Toxicology

Anatomic Pathology

Cancer Genomics

Molecular Diagnostics

Pharmacogenomics

Immunology

Confronting the Genetic Testing Billing Maze

Billing codes & rules for genetic tests change rapidly, while payer policies lag. From pharmacogenomics to hereditary cancer risk panels, genetic tests involve:

  • Multiple CPT codes for each test component
  • Challenging coding for multi-gene panels
  • Specific payer-covered indications
  • Unique modifiers to convey medical necessity
  • Different processes for each payer

Even claims coded properly are denied frequently, costing labs significant revenue. Our clients have experienced appeal success rates exceeding 90%, proving that many denials are unjustified. However, incorrect appeals take time and dedicated staff.

Tailored Genetic Testing Billing Services

With decades of experience across leading labs nationwide, AltuMED brings specialized expertise in genetic testing billing. Our extensive knowledge spans billing intricacies for:

  • Pharmacogenetic panels
  • Multi-gene hereditary cancer panels
  • Expanded carrier screening
  • Whole exome/genome sequencing
  • Hereditary heart disease panels
  • Other molecular genetic testing billing services

We combine this expertise with advanced technologies and workflows customized for genetic tests. Robust claim scrubbing catches errors before submission. Ongoing specialist training adheres to the latest genetic billing protocols. Integrated workflows align billing with your unique lab operations.

Complete Revenue Cycle Management

We manage your genetic testing revenue cycle from start to finish, offering:

  • Patient eligibility verification prior to sample collection
  • Accurate CPT code selection before testing
  • Rigorous claim editing to prevent rejections
  • Rapid electronic submission to all contracted payers
  • Tracking and follow-up until claims are paid
  • Appealing improper denials for maximum reimbursement
  • Custom reporting for revenue analytics

Faster payments, lower admin costs, and more time for patient care.

Expert Billing Partnership

In-house genetic testing billing needs substantial investments in technology, staff, and education. AltuMED provides turnkey billing solutions through an affordable and scalable platform.

As your trusted partner, our experts:

Give ongoing advice tailored to your lab’s payer mix and test volumes

Amend existing payer contracts to enhance genetic testing coverage

Negotiate improved reimbursement for new test offerings

Recommend optimal tests to order based on the likelihood of payment

Act as an extension of your team to maximize revenue

Partner with AltuMED and overcome the obstacles of Genetic Testing billing.

Contact us today for a free assessment.

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