Unfortunately, it is also time-consuming and expensive. Many times, undergoing genetic testing requires prior authorization by a doctor, which is followed by a complicated matrix of requirements that involve multiple stakeholders. Then, even after a prior authorization has been obtained, a lab will still need to verify the authorization, which can create a back-and-forth dialogue that can delay the process and even negate reimbursement if an insurer refuses to pay.
Which is why the Inova Personalized Health Accelerator (IPHA) is rolling out CoverMyTest, a software system designed to streamline and automate the workflow for prior authorizations. The infrastructure will help expedite patient care and allow labs and physicians to efficiently conduct patient eligibility checks, deliver electronic prior authorizations and collect insurance verification.
In 2019, Lesley Anderson, Director of Business Development, Inova Genomics Laboratory, anticipates that more than 3,000 of about 10,000 patients receiving genetic testing at Inova will need preauthorization.
“Physicians care about this because they want to know when the lab results are in, and the lab cares about where we are in that process of getting everything authorized,” says Rick Gordon, Co-Director of IPHA. “This gives everybody visibility, making sure patients can get the tests they need.”
Care Tailored to You
Learn more about genomics and the Inova Center for Personalized Health.
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