" "
Satellite Banner
Molecular & Clinical Diagnostics
Scientific Community
 
Become a Member | Sign in
Home>News>This Article
  News
Return

Genetic Technologies Executes Agreement with Nationwide Provider Network

Published: Friday, May 03, 2013
Last Updated: Friday, May 03, 2013
Bookmark and Share
Genetic Technologies Limited announces that it has executed an agreement with Three Rivers Provider Network, Inc. of Chula Vista, California, USA.

Three Rivers Provider Network (“TRPN”) claims to be the largest supplemental PPO Network Foundation in the US, providing healthcare benefits to more than 10 million members, at more than 1 million locations nationwide.

Under the agreement, BREVAGen™ patients covered by insurers that are part of the TRP Network will have their claims adjudicated as “in network”, expediting the claim processing at an agreed discount.

The agreement with TRPN is the fifth such credentialing agreement executed between the Company and similar US Preferred Provider Organisations (“PPOs”) and increases the total number of covered lives, for which its BREVAGen™ test could be adjudicated as “in-network”, to more than 23 million.

The impact of this credentialing has been clearly demonstrated in reviewing reimbursement claims for the BREVAGen™ test since its launch. As reported recently by the Company in its March 2013 Quarterly Activities Report, the average reimbursement received in respect of claims that were adjudicated as “innetwork” was more than 25% higher than the amounts received in respect of claims that were adjudicated as “out of network”, with the time taken to collect the funds also being materially shorter.

Importance of credentialing contracts executed with Preferred Provider Organisations

As mentioned, credentialing with PPOs such as TRPN allows for expedited claim adjudication as “innetwork”. This provides improved cash flow via faster payment while still obtaining an acceptable level of reimbursement, and also reduces the costs incurred through appealing denials. Once BREVAGen™ sample volumes reach a significant level and Genetic Technologies has gathered any necessary clinical utility data, the Company will approach insurers directly to contract.

A PPO is a managed care organisation of medical doctors, hospitals and other health care providers who has covenanted with an insurer or a third-party administrator to provide health care at reduced rates to the insurer’s or administrator’s clients. Credentialing is a process whereby provider organisations such as physicians, care facilities and ancillary providers (including testing service providers such as GTG’s subsidiary, Phenogen Sciences) contract directly with the PPO. Contracts with PPOs are fundamental to having claims for the BREVAGen™ test adjudicated “in-network”.

Credentialing contracts have now been executed with Three Rivers Provider Network, Prime Health Services, National Preferred Provider Network / PlanCare America / Ohio Preferred Provider Network LLC (NPPN / OPPN), Galaxy Health Network and Fortified Provider Network. The Company is now actively pursuing agreements with other PPOs in order to further extend access to an increased number of covered lives.


Further Information

Join For Free

Access to this exclusive content is for Technology Networks Premium members only.

Join Technology Networks Premium for free access to:

  • Exclusive articles
  • Presentations from international conferences
  • Over 2,900+ scientific posters on ePosters
  • More than 4,200+ scientific videos on LabTube
  • 35 community eNewsletters


Sign In



Forgotten your details? Click Here
If you are not a member you can join here

*Please note: By logging into TechnologyNetworks.com you agree to accept the use of cookies. To find out more about the cookies we use and how to delete them, see our privacy policy.


Scientific News
‘Smelling’ Prostate Cancer
A research team from the University of Liverpool and the University of the West of England (UWE Bristol) has reached an important milestone towards creating a urine diagnostic test for prostate cancer that could mean that invasive diagnostic procedures that men currently undergo eventually become a thing of the past.
Criminal Justice Alcohol Program Linked to Decreased Mortality
Institute has announced that in the criminal justice alcohol program deaths dropped by 4.2 percent over six years.
Charting Kidney Cancer Metabolism
Changes in cell metabolism are increasingly recognized as an important way tumors develop and progress, yet these changes are hard to measure and interpret. A new tool designed by MSK scientists allows users to identify metabolic changes in kidney cancer tumors that may one day be targets for therapy.
Individuals' Medical Histories Predicted by their Noncoding Genomes
Researchers have found that analyzing mutations in regions of the genome that control genes can predict medical conditions such as hypertension, narcolepsy and heart problems.
'Molecular Movie' Opens Door to New Cancer Treatments
An international team of scientists led by the University of Liverpool has produced a 'structural movie' revealing the step-by-step creation of an important naturally occurring chemical in the body that plays a role in some cancers.
Advancing Synthetic Biology
Living systems rely on a dizzying variety of chemical reactions essential to development and survival. Most of these involve a specialized class of protein molecules — the enzymes.
Preparing for Potential Zika Outbreaks
Experts at the European Society of Clinical Microbiology and Infectious Diseases (ESCMID) are developing tools to monitor the spread of the Zika virus and are conducting research to gather more solid data to better assess the risks associated with the infection.
What do Banana Peels and Human Skin Have in Common?
Human skin and banana peels have something in common: they produce the same enzyme when attacked. By studying fruit, researchers have come up with an accurate method for diagnosing the stages of this form of skin cancer.
Biomarker for Recurring HPV-Linked Oropharyngeal Cancers
A look-back analysis of HPV infection antibodies in patients treated for oropharyngeal (mouth and throat) cancers linked to HPV infection suggests at least one of the antibodies could be useful in identifying those at risk for a recurrence of the cancer, say scientists at the Johns Hopkins University.
Counting Cancer-busting Oxygen Molecules
Researchers from the Centre for Nanoscale BioPhotonics (CNBP), an Australian Research Centre of Excellence, have shown that nanoparticles used in combination with X-rays, are a viable method for killing cancer cells deep within the living body.
Skyscraper Banner

Skyscraper Banner
Go to LabTube
Go to eposters
 
Access to the latest scientific news
Exclusive articles
Upload and share your posters on ePosters
Latest presentations and webinars
View a library of 1,800+ scientific and medical posters
2,900+ scientific and medical posters
A library of 2,500+ scientific videos on LabTube
4,200+ scientific videos
Close
Premium CrownJOIN TECHNOLOGY NETWORKS PREMIUM FOR FREE!