For Labs

CGI helps high quality genetic, genomic, and complex biomarker tests stand out.

Helping quality lab tests stand out

Clinical laboratories with high quality genetic, genomic, and biomarker tests have found it increasingly difficult to differentiate their laboratory services from a proliferation of sub-standard competitors. CGI's ELEVATEGENETICS® initiative aims to help laboratories with high quality tests prove their diagnostic tests' quality to health insurers.

Reimbursement challenges

While it is a requirement for insurance reimbursement that laboratory tests meet professionally recognized standards for health care, health insurance payers and clinicians have not had easy and reliable insight into which diagnostics follow best practices, and which do not. Reliance on laboratory level certifications (ie. CLIA and CAP) has been unable to ensure that tests from most certified labs adhere to professionally recognized standards. As a result many doctors have been choosing poor quality diagnostic tests for their patients, and payers have been reimbursing many of the poor quality tests.

The Solution

Since 2018, CGI has been working with many of the nation's health insurance payers to develop and implement ELEVATEGENETICS® quality assessment services. These services provide test-level accuracy, clinical validity, and billing integrity metrics for clinical genetic and genomic biomarker tests. ELEVATEGENETICS services are unique because they measure laboratory tests against professionally recognized medical and scientific standards, as required by most state-level legislation mandating insurance coverage of biomarker tests.

Through CGI's ELEVATEGENETICS quality assessment services, laboratories with high quality genetic and genomic biomarker tests, that bill true, will be able to prove their value to stakeholders and gain better traction in out-competing their substandard competitors.