Insurance Alignment

Insurance Alignment to guide national consensus policies related to laboratory tests, provide a framework and guidance to build partnerships with local payors to improve efficiencies around test review, and improve reimbursement outcomes. This will ultimately increase testing approval for patients who meet medical necessity criteria. The following PLUGS policies may be used by insurance payors, laboratories, providers, families, and consumer groups to improve efficiency and reimbursement for rational genetic testing. Microsoft Word versions available upon request.


Insurance Alignment Committee

the PLUGS Insurance Advocacy Sub-Committee is working to create best practices, as well as tools for implementation and engaging payers.

Committee Chairs:

Jodie Vento, MGC, LCGC

Manager, Center for Rare Disease Therapy
Genetic Counseling Supervisor, Laboratory Services
Children’s Hospital of Pittsburgh of UPMC

Working Groups:

  • CPT Codes
  • Preauthorization
  • Policy Guidelines

National Committee for Laboratory Stewardship (NCLS)

Mission
Improve the quality and value of clinical care by establishing national standards for laboratory test utilization.

Vision
To promote and enable the highest standards of effective test utilization in every clinical setting.

More information on NCLS