Creating the Genomics AI Coalition
April 20, 2023
I propose the formation of the Genomics AI Coalition (GACT) – applying artificial intelligence and machine learning to genomics (AI/ML-Gen) in the areas of
Call to Action #3 – Insurance company coverage information
Genetic testing costs have decreased substantially, which should eliminate payers having different policies for coverage and reimbursement. With genetic testing the third most common treatment for prior authorization, we need to streamline this process.
Questions to Ask
As we approach the heath insurance payers, what questions should we ask about their business policies to support further adoption of clinical genomics? Here is my initial list. Please provide your feedback below, and together, let’s help solve these coverage and pre-authorization issues.
- Do you have the ability online for a patient to see their plan coverage of genetic testing, including multi-gene panels and whole genome sequencing?
- Do you have the ability online for a patient to determine their out-of-pocket costs for genetic testing?
- Do you show and explain plan coverage for genetic counseling services?
- How could payers go about co-developing a streamlined genetic test selection, pre-authorization, and test ordering process, in partnership with EHR vendors and the health care systems?
Provide feedback
Do you have suggestions or feedback regarding this Call to Action? What steps or solutions do you suggest to meet these goals? Have you taken action and has it resulted in a particular outcome? Provide your comments using the form below or feel free to send an email directly to moveforward@genomics.network.
I will use the feedback provided to create additional posts around this topic which you will be able to view on this page. Please note that no identifying information will be included in anything posted on this website unless such identification is consented.
Response Posts to CTA#3
Check back soon for response posts to the feedback provided on this topic
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