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Medical Insurance Providers and their Policy Staff  who need researched information to assist with policy development and timely update of their policies may engage our services. We would be pleased to contract with you to provide expert consultative services to your medical directors and policy team, by way of the research you request, on-going policy review or assistance with Case Review. 

We offer the following Consultative Services:   

  • Consultation to Medical Directors for either Case Review or Policy discussion,  by either case, hourly, or retainer contract.
  • Assistance to your Medical Support Staff and Medical Directors for research and technical review for Genetic Testing and/or  Counseling Policies.
  •  Direction and Consultation to your own Medical Review Team in determining testing eligibility.  We  also have avenues for your oursourcing of this component of work as pertains to eligibility for Cancer Predispostional Testing and Management of such patients (similar to Cigna, Aetna and  UnitedHealthcare).
  • Expertise to write or edit your current Genetic Testing Policy, by hourly or policy item contract. 
  • Contracts for Patient Genetic Counseling or Assessment, as required. 

For insurers who may have arrangements with genetic testing laboratories for genetic testing eligibilty or genetic counseling assistance, we acknowledge the role of such services for the great assistance which they can provide in the way of testing coordination and in helping you to locate the testing that you request.   However,  Genetic Counseling Services can be your first stop for collecting and verifying confidential family history information and records.  Accurate information before any testing is begun, will set your patients on the right path for any genetic testing which may be considered.  Family history information is key in genetic testing decision making.  Genetic Counseling Services is not affiliated with any genetic testing laboratory, therefore we have no bias towards or against genetic testing of any type.  Insurance administrators should be aware of state laws which require that elements of informed consent and genetic counseling be satisfied and documented to the patient chart for any genetic testing be ordered.  Some state laws and Insurers prohibit that genetic counseling be performed by the testing laboratory.       

 

The following organizations, guidelines or position statements support the role of genetic counseling in patient risk assessment and healthcare management:

National Accreditation Program for Breast Centers

Colorectal Recommendations/Center for Disease Control

American College of Surgeons

Working Group for Evaluation of Genomic Applications in Practice and Prevention (EGAPP)/ Center for Disease Control

American College of Obstetricians and Gynecolgists

US Preventative Task Force Guidelines

Society of Surgical Oncology (SSO)

SSO Prophylactic Surgery Statement

SSO Genetic Testing Statement

American Society of Clinical Oncology 

American Society of Clinical Oncology Policy Statement Update

Society of Gynecologic Oncology

American Gastroenterological Association

Melanoma Genetics Consortium

National Society of Genetic Counselors

National Comprehensive Cancer Network

Re: Cardiac Genetic Testing

Please Contact Us for further information.



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