Magellan Healthcare partners with Concert Genetics to provide solution that offers efficient genetic testing management, improved quality, accurate payment; genetic testing expected to grow 13% annually with average of 6.9 billing codes per test

Sample article from our Health Care Sector

FRISCO, Texas , May 4, 2022 (press release) –

New end-to-end Genetic Testing Solution addresses overpayments and waste while driving value for providers, payers, and members

Magellan Healthcare, the behavioral health and specialty division of Magellan Health, Inc., today announced a new collaboration with Concert Genetics, a software and managed services company that provides the data and digital infrastructure to manage genetic testing. Working together, the two companies will offer an innovative, end-to-end solution that leverages Magellan’s utilization management processes and claims integrations to deliver efficient management, improved quality, and accurate payment in genetic testing.

The genetic testing landscape has changed dramatically and continues to evolve. With more than 175,000 orderable tests on the market1 and an estimated annual growth rate of 13%,2 the rapid expansion of genetic testing, combined with its complexity, is challenging stakeholders across the healthcare system. Variation in coding and billing generates ambiguity and can lead to unnecessary review costs. Thousands of code variations exist, and on average, 6.9 codes are billed per test.3 Complex coding in a rapidly evolving field can lead to challenges with managing administrative processes, such as claims editing.

Due to the volume of tests available, the effort required to manage genetic testing can seem endless. Despite accounting for 1%-2% of medical spend, health plans can dedicate as much as 15% of clinical reviews and 20% of medical policies to this area. Additionally, current medical policies for genetic tests can be difficult to navigate, leading to inconsistent application and errors, and often fall behind the continuously evolving landscape of new tests, evidence, and guidelines.

The new solution will combine an authoritative catalog of genetic tests and unique test ID system with regularly updated medical policies, test-specific coding standards, lab quality information, and real-time claim editing capabilities, all delivered through Magellan’s proven delegated delivery model.

“Magellan Healthcare’s new genetic testing solution will enable health plans to manage variation and risk while reducing administrative burden and medical costs,” said Sajel Lala Kana, M.D., FACMG, board-certified geneticist and physician clinical reviewer for Magellan Healthcare. “Removing the ambiguities surrounding genetic tests, codes, and medical policies opens the door to a new, innovative approach that supports payers in this complex space.”

Webinar on genetic testing

Tuesday, May 24, 2022, 2:00-3:00 p.m. ET: Join us during Public Health Genetics Week for the Magellan Healthcare webinar, “Rare Disease Genetic Testing—Access and Diagnosis, and Direct-to-Consumer vs. Clinical Testing.” Magellan Healthcare’s Dr. Sajel Kana, board-certified clinical geneticist, and Concert Genetics’ Dr. Gillian Hooker, board-certified genetic counselor and molecular biologist, will address the genetic testing landscape, access to genetic testing for rare diseases and more common uses, as well as the differences between direct-to-consumer and clinical genetic tests. Click here to register.

To learn about Magellan Healthcare’s end-to-end genetic testing solution, visit

About Magellan Healthcare: Magellan Healthcare, Inc., the healthcare business unit of Magellan Health, Inc., offers solutions for complex conditions in the areas of behavioral health and medical specialty treatment. Magellan Healthcare serves commercial health plans, employers, state and local governments, and the Federal government, including the Department of Defense. For more information, visit

About Magellan Health: Magellan Health, Inc., is a leader in managing the fastest growing, most complex areas of health, including special populations, complete pharmacy benefits and other specialty areas of healthcare. Magellan supports innovative ways of accessing better health through technology, while remaining focused on the critical personal relationships that are necessary to achieve a healthy, vibrant life. Magellan's customers include health plans and other managed care organizations, employers, labor unions, various military and governmental agencies and third-party administrators. For more information, visit


1 Concert Genetics, 2022
2 Fortune Business Insights, 2021
3 Concert Genetics, 2019

View source version on

Media Contact: Lilly Ackley,, (860) 507-1923

Source: Magellan Health, Inc.

* All content is copyrighted by Industry Intelligence, or the original respective author or source. You may not recirculate, redistrubte or publish the analysis and presentation included in the service without Industry Intelligence's prior written consent. Please review our terms of use.

See our dashboard in action - schedule an demo
Dan Rivard
Dan Rivard
- VP Market Development -

We offer built-to-order health care sector coverage for our clients. Contact us for a free consultation.

About Us

We deliver market news & information relevant to your business.

We monitor all your market drivers.

We aggregate, curate, filter and map your specific needs.

We deliver the right information to the right person at the right time.

Our Contacts

1990 S Bundy Dr. Suite #380,
Los Angeles, CA 90025

+1 (310) 553 0008

About Cookies On This Site

This website stores cookies on your computer. These cookies are used to improve your website experience and provide more personalized services to you, both on this website and through other media. To find out more about the cookies we use, see our Privacy Policy. We won't track your information when you visit our site. But in order to comply with your preferences, we'll have to use just one tiny cookie so that you're not asked to make this choice again.