Corporate Banner
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
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 2,500+ scientific posters on ePosters
  • More than 3,700+ 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
The Changing Tides of the In Vitro Diagnostics Market
With the increasing focus in personalized medicine, diagnostics plays a crucial role in patient monitoring.
Poor Survival Rates in Leukemia Linked to Persistent Genetic Mutations
For patients with an often-deadly form of leukemia, new research suggests that lingering cancer-related mutations – detected after initial treatment with chemotherapy – are associated with an increased risk of relapse and poor survival.
'Fountain of Youth' Protein Points to Possible Human Health Benefit
Patients with higher blood levels of growth factor have lower risk of cardiovascular problems.
Signature of Microbiomes Linked to Schizophrenia
Studying microbiomes in throat may help identify causes and treatments of brain disorder.
Imaging Software Could Speed Breast Cancer Diagnosis
Technology could improve access to diagnostic services in developing countries.
Data Mining DNA For Polycystic Ovary Syndrome Genes
A new Northwestern Medicine genome-wide association study of PCOS – the first of its kind to focus on women of European ancestry – has provided important new insights into the underlying biology of the disorder.
Algorithm Interprets Breathing Difficulties to Aid in Medical Care
Researchers from North Carolina State University have developed an efficient algorithm that can interpret the wheezing of patients with breathing difficulties to give medical providers information about what’s happening in the lungs.
Researchers Develop qPCR Prognosis Test for NSCLC Patients
A nine-gene molecular prognostic index (MPI) for patients with early-stage non-small cell lung cancer (NSCLC) was able to provide accurate survival stratification and could potentially inform the use of adjuvant therapy in patients struggling with the disease.
Genetic Test Could Improve Blood Cancer Treatment
Testing for genetic risk factors could improve treatment for myeloma – a cancer of the blood and bone marrow – by helping doctors identify patients at risk of developing more aggressive disease.
PTR-MS Breath Test Shows Potential for Detecting Liver Disease
Researchers at the University of Birmingham have published results that suggest a non-invasive breath test for liver disease using an IONICON PTR-MS.
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
2,500+ scientific and medical posters
A library of 2,500+ scientific videos on LabTube
3,700+ scientific videos
Close
Premium CrownJOIN TECHNOLOGY NETWORKS PREMIUM FREE!