Several years ago, Aetna started tracking testing patterns in the community healthcare setting following accounts from payors that doctors were inappropriately ordering BRCA testing to assess women at higher hereditary risk for breast and ovarian cancer. Historically, genetic testing policies haven't adequately addressed ordering providers' needs since policy-writers didn't have practical knowledge of genetics in medicine." "We want to modify policies so they are practical, covering tests that should be covered. As a result, patients "are just denied coverage for testing," Trivedi said. At insurance companies, those reviewing genetic testing claims may not understand why a test might be medically relevant. For example, a few years ago the company began providing genetic counseling services to Cigna members considering testing for breast cancer risk, colorectal cancer syndromes, and Long QT syndrome.Ī critical part of the services InformedDNA provides for insurers involves reviewing claims for genetic testing. InformedDNA is experienced in this regard. In this environment, it requires genetics expertise to know when a test is necessary and when it isn't, and what types of tests to order. There has been an "explosion of new genetic tests" being put on the market, she said.Īccording to healthcare technology firm NextGxDx, there are around 60,000 commercially available genetic testing products in the US market, and on average labs are launching 10 new tests daily. Over the past year-and-a-half Trivedi has noted growing interest among health plan providers for genetic testing benefits management services. Trivedi further explained that the partnership between the two firms focuses on genetic testing utilization management. "InformedDNA and AIM are collaborating on a joint product that supports all types of genetic testing and is not limited to any specific areas." " is becoming an integral part of medicine," Amber Trivedi, senior VP of provider and client services for InformedDNA, told GenomeWeb. InformedDNA, an independent network of genetics specialists, is collaborating with AIM so it can draw on InformedDNA's expertise to guide appropriate use of genetic testing in line with medical guidelines and payer policies. The company provides specialty benefits management services to a variety of payors in radiology, cardiology, oncology, sleep management, and specialty drugs.
NEW YORK (GenomeWeb) – AIM Specialty Health has partnered with InformedDNA to help health plans manage appropriate genetic testing use and increase patients and physicians' access to genetics professionals.ĪIM is a benefits management company and an affiliate of national insurer Anthem. Advances in Clinical Genomics Profiling.
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