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    Webinar: Patient First, Payer Aligned: The New Era of Lab Stewardship

    Laboratory testing sits at the crossroads of care delivery and cost control. This webinar explores how payers view lab stewardship,…

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    Diagnostic Intelligence

    Diagnostic Intelligence is Avalon’s science-driven framework for managing and analyzing diagnostic testing at scale.

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    Personalized, Value-based Care

    How Avalon uses lab data and predictive analytics to reduce costs, align resources, and support equitable care.

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    See how Avalon’s Diagnostic Intelligence delivers measurable value across roles and specialties—from health plans to labs, genetics to oncology.

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    Annual Lab Trend Report: The Sentinel Guide to Smarter Lab Testing

    Avalon’s Lab Trend Report is the sentinel, one-of-a-kind industry publication that has become a trusted benchmark for understanding how clinical…

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    Explore Avalon’s latest research, insights, and events—everything you need to stay ahead in diagnostic innovation and value-based care.

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    The Benefits and Challenges of Precision Medicine for Health Plans

    Precision medicine is redefining the future of healthcare by using genetic and biomarker testing to deliver treatments tailored to each…

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    Learn who we are—our mission, vision, values, leadership, and the story behind Avalon’s role as the driving force in diagnostic intelligence.

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Benefit Management

Optimizing Diagnostic Utilization and Spend

Our Benefit Management solutions apply rigorous clinical science, evidence-based policies, and real-time enforcement technology to ensure the right tests are performed at the right time—no more, no less.

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Key Capabilities

Evidence-based policies

and rules for automated reimbursement policy adherence across diagnostic and clinical spend areas (lab, radiology, specialty medications, etc.)

Network Management

with 375+ curated lab providers and over 150 contracted labs, ensuring access to high-quality testing with reduced costs.

Automated Policy Enforcement

using our patented APEA technology, adjudicating millions of claims monthly in real time.

Lab Benefit Management

(LBM) for routine and genetic testing, including delegated NCQA-accredited utilization management.

Outcomes Delivered

25%

average savings on member out-of-pocket costs.

10–20%

cost savings across outpatient lab benefits.

<0.01%

provider reconsideration rates.

Benefit Management Products

Routine Test Management

Drive lab testing that aligns with science—not guesswork. Our solution enforces evidence-based guidelines to deliver deep savings for payers—going beyond traditional payment integrity and network strategies.

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Precision Genetic Management

Elevate payer approaches to complex genetic testing by integrating lab networks, enforcing guidelines, leveraging insights, and improving claims intelligence. Navigate the evolving landscape confidently to turn precision testing into a practical, scalable solution.

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AvalonSelect Genetic Network

Streamline genetic test management and control costs while reducing work and delivering quality, appropriate genetic testing. This ensures members get their test without delays or waste, leading to smarter use, better outcomes, and more confidence.

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Ensure the right tests are performed at the right time.

Find out how Avalon’s Benefit Management solutions can help your practice or health plan today.

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