Availity and Concert Join Forces for Genetic Testing Innovation
Availity, a leader in real-time health information networking, and Concert, known for its clinical content and payment accuracy solutions, have announced a groundbreaking partnership. They aim to digitize and streamline the prior authorization process for genetic testing. This collaboration promises to enhance transparency, consistency, and speed, ultimately alleviating administrative burdens within the healthcare system.
The Need for Change in Genetic Testing
As the field of genetic diagnostics grows, the personalization of patient care is becoming more accessible. However, genetic testing is often associated with high administrative costs and complexities. These tests frequently require prior authorizations, which can slow down the delivery of care and lead to frustrations for providers and patients alike. With a multitude of codes involved—ranging from two to ten for common tests in prenatal, oncology, and pharmacogenetics—claims are often subjected to manual reviews, increasing the likelihood of setbacks.
Streamlining Processes with Technology
To tackle these challenges, Availity and Concert are integrating their respective expertise to refine the authorization process. By fusing Concert’s clinical criteria and coding standards with Availity’s End-to-End Authorization solution, they anticipate a significant shift in workflow efficiency for providers. This integration is set to automate numerous processes that are typically manual and prone to errors.
Anticipated Benefits of the Partnership
The anticipated outcomes of this collaboration highlight the distinct advantages for all stakeholders involved:
- Providers will benefit from increased transparency and quicker authorizations, often delivered instantly.
- Health plans will enjoy a more streamlined authorization process, reducing the workload on medical directors.
- Patients will face fewer delays when accessing genetic testing and will see a reduction in unexpected billing.
Quotes from Leadership
Rob Metcalf, CEO of Concert, expressed enthusiasm for the partnership, stating, "At Concert, we envision a day when laboratory test reimbursement is determined instantly at the point of patient care. Our collaboration with Availity will facilitate this vision by powering an efficient network that supports evidence-based precision health."
Similarly, Matt Cunningham, Executive Vice President of Product at Availity, said, "Our partnership with Concert reflects our commitment to enhancing patient access to critical care by automating complex authorization requests that typically consume significant time and resources."
About Availity
Availity stands as the largest real-time health information network in the nation. Their primary goal is to enable seamless connectivity and collaboration among payers, providers, and trading partners. By delivering intelligent and interoperable solutions, Availity maximizes healthcare efficiency and fosters transparency, creating a transformative experience for patients.
About Concert
Founded with the mission to improve access to genetic testing, Concert leverages its unique technology to bridge the gap between evidence, policy, and payment. With a focus on enhancing accuracy in payment systems, Concert's platform is designed to streamline the diagnostic test ordering and reimbursement processes.
Frequently Asked Questions
What is the main goal of the partnership between Availity and Concert?
They aim to automate and digitize the prior authorization process for genetic testing, making it more efficient and transparent.
How will this partnership affect providers?
Providers can expect quicker, more consistent authorizations, fewer manual interventions, and ultimately a reduction in administrative burden.
What benefits do patients gain from this collaboration?
Patients will experience faster access to genetic testing without the stress of unexpected bills due to improved authorization processes.
What technologies are being integrated?
Concert's clinical criteria and coding standards are being combined with Availity's End-to-End Authorization solution.
What is Availity's mission?
Availity aims to create transformative healthcare experiences by facilitating seamless exchanges of clinical, administrative, and financial information.
