Let's Make a Deal: Working Together to Navigate Coverage, Billing, and Coding Whammies

Genetic counselors bear much of the brunt of the ineffective billing and reimbursement system in the care of their patients. We strive to build trust and understanding among our patients, enabling them to benefit from the advancements in genomic science and precision medicine. A persistent misperception exists that reimbursement for genetic testing is solely driven by policy coverage. Furthermore, limited efforts have been made to implement systemic changes that can truly improve the current situation. Genetic counselors are increasingly taking on leadership roles in the billing and reimbursement system, whether in clinics, laboratories, or within the payers. This session aims to provide an in-depth look into the machinery of genetic test reimbursement and empower the genetic counseling community to actively contribute to developing a more equitable and efficient system.

Presented by:
1. Charlotte Skinner, MS, MPH, CGC
2. Erica Vaccari, MS, CGC
3. Sarah Soto, MS, CGC
4. Susan Hahn, MS, CGC
5. Marissa Clark, MS, CGC
6. Lucy Langer, MD, MSHS  

Learning Objectives:
1.Explain the genetic testing reimbursement landscape and ways you can improve genetic testing access for your patients
2. Identify key complexities in policy language, coding, and billing that muddle the utilization of genetic testing
3. Cite the evidence around common reasons for denials of testing claims submitted to insurers
4. Distinguish unique challenges in Medicaid, Medicare and commercial insurance billing environments and implications for equitable access to testing
5. Describe the path to reimbursement for a new-to-market diagnostic test 6. Provide billing best practices and tangible steps to increase the likelihood of appropriate patients utilizing his/her medical benefits 

Continuing Education Unit Approval:
The National Society of Genetic Counselors (NSGC) has authorized National Society of Genetic Counselors (NSGC) to offer up to 1.5 Category 1 contact hours for Let's Make a Deal: Working Together to Navigate Coverage, Billing, and Coding Whammies. The American Board of Genetic Counseling (ABGC) will accept CEUs earned at this program for the purposes of genetic counselor certification and recertification. 

Successful Completion:
1. View recording
2. Pass quiz
3. Complete evaluation