Genetic molecular lab testing preauthorization program
Capital offers an innovative genetic molecular lab testing preauthorization program designed to guide the best possible care for our members while balancing cost to best serve our customers.
Our genetic molecular lab testing preauthorization program is supported by a team of doctors who can provide an expert-level review for evidence-based care for specific tests (listed below). Más revisiones de autorización previa especializadas pueden significar mejores resultados, costos reducidos y procedimientos más seguros. Le mostramos cómo:
- Mejor seguridad y calidad para sus empleados.
- Plan de tratamiento adecuado, basado en la evidencia, manejo e intervenciones.
- Soporte de red mejorado.
- Reducción de los costos de atención.
- Atención basada en la historia clínica y el diagnóstico del paciente.
What tests are covered?
The following genetic molecular lab tests are covered for outpatient services (inpatient services do not require preauthorization):
- Hereditary cancer syndromes.
- Carrier screening tests.
- Tumor marker / molecular profiling.
- Immunohistochemistry (IHC).
- Hereditary cardiac disorders.
- Cardiovascular disease and thrombosis risk variant testing.
- Pharmacogenomics testing.
- Neurologic disorders.
- Mitochondrial disease testing.
- Intellectual disability / developmental disorders.
Políticas médicas
Visit eviCore healthcare for more information about these medical policies.
Si tiene preguntas, comuníquese con su ejecutivo de cuentas de Capital Blue Cross.
Capital Blue Cross contracts with eviCore healthcare (eviCore) to review requests for certain services for medical necessity and appropriateness on behalf of capital Blue Cross members.