Expanded solution, clinical advisory board,
and new website set a path to bring transparency and efficiency to
a growing set of health services
NASHVILLE, Tenn., May 1, 2024
/PRNewswire/ -- Concert has expanded its Diagnostic Benefit
Program, formerly known as the Genetics Benefit Program, to provide
payment and clinical policies and payment accuracy capabilities
across routine and advanced laboratory testing, enabling health
plans to provide their members with access to these important
clinical services at lower total costs, the company announced
today.
"Diagnostics are critical in the delivery of effective,
personalized care. Unfortunately, ambiguity in coverage, coding,
and reimbursement leads to waste and confusion as providers,
laboratories, and health plans work together to serve patients,"
said Rob Metcalf, CEO of Concert.
Laboratory testing has become complex and costly to manage, as
new tests, evidence, clinical guidelines, and codes emerge rapidly.
This quarter, almost 60 applications for Proprietary Laboratory
Analyses (PLA) codes are under
consideration.1 Meanwhile, frequently
ordered molecular oncology, pharmacogenetic and infectious disease
tests are commonly billed with more than 10
codes,2 often obscuring the test that
was performed. As a result of the rapid changes underway, many
health plans' policy and coding configurations lag behind the
market, and payment errors are common.
The Diagnostic Benefit Program provides transparent,
evidence-based policies, a synchronized library of claim edits, and
technical integration capabilities that can deliver this content
through the customer's preferred clinical decision support and
claims editing platforms. Together these enable plans to improve
transparency, reduce administrative burden and achieve cost
savings, all while keeping pace with the rapidly evolving
market.
In a separate release, Concert announced the formation of a
clinical advisory board, which will advise Concert on its expanding
set of clinical policy content. Advisors include Drs. Beth Harris, Thomas
Holland, Girish Putcha, and
Michele Schoonmaker.
"Expanding our clinical content, and the expertise that supports
its development, means Concert can bring transparency, efficiency,
and accurate reimbursement to more areas of care," said
Gillian Hooker, Concert's Chief
Scientific Officer. "Our goal is to deliver clarity of coverage and
costs all the way to the point of care, and today's announcements
represent important progress towards that goal."
More information about the Diagnostic Benefit Program and the
clinical advisory board can be found at Concert's new website at
www.concert.co. With today's announcement, Concert Genetics will
now operate by its abbreviated name, Concert, which many customers
and partners have used for years to refer to the company.
About Concert
Concert is a healthcare technology
company enabling cost-effective access to diagnostics and
therapeutics by harmonizing evidence, policy, and payment. Founded
in 2010 to bring transparency and efficiency to genetic testing,
Concert now offers the definitive precision health payment accuracy
platform. The company combines proprietary market data, clinical
and coding expertise, and patented technology to support diagnostic
test ordering, resulting, coding, coverage, claim editing, and
payment integrity. For more information, visit www.concert.co
1 For more information on
CPT® PLA codes visit:
https://www.ama-assn.org/practice-management/cpt/cpt-pla-codes.
CPT® is a registered trademark of the American Medical
Association.
2 Concert data
Contact: Nick Tazik,
ntazik@concert.co
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SOURCE Concert