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Benefit Management

AvalonSelect Genetic Network

Simplify the complexity of genetic testing while delivering measurable value through cost savings, enhanced outcomes, and operational efficiency.

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Genetic testing management is increasingly complex

With over 175,000 clinical genetic tests on the market—and 10 new tests introduced daily—ensuring quality, cost-effective access to diagnostics is becoming exponentially harder for health plans. The rapid pace of innovation demands a partner with both scientific and deep network management expertise.

At the same time, laboratories—the vital engines of diagnostic innovation—are facing mounting challenges that disrupt the entire ecosystem. Regulatory mandates to reduce prior authorization burden, complex state biomarker legislation, and reimbursement delays create operational and financial strain. Labs are often left navigating inconsistent policies and lengthy reconsideration processes without payment assurance, while health plans remain unsure of the clinical value behind billed tests.

Simplify genetic testing management, while improving quality

As a core offering within Avalon’s Diagnostic Intelligence suite, AvalonSelect helps health plans simplify genetic test management, reduce costs and administrative burden, and improve the quality of genetic testing for their members.

Genetic testing management complexity

Reduce or eliminate Prior Auth for gold-carded providers

Drive quality enforcement through strict criteria for labs

Manage genetic testing spend and network complexity

Increase savings with national fee schedule

Drive innovation and pace with science without administrative burden

10+%

savings on overall genetic test spend with contracted preferred network & negotiated fee schedule

What is the AvalonSelect Genetic Network?

Avalon’s genetic network is a select group of preferred genetic labs coupled with robust consultative services that complement a health plan’s existing routine lab network. Health plans can continue to leverage their current lab relationships while outsourcing the management of genetic testing, pricing, compliance enforcement, test quality assessment, new test evaluation, and contracting to Avalon.

Curated, High-Performing Genetic Lab Network

The AvalonSelect Genetic Network includes a nationwide preferred network directly contracted with Avalon and a negotiated fee schedule. Preferred lab providers are invited to participate in our network based on quality performance.

Select providers who consistently meet Avalon’s quality standards and demonstrate high prior authorization approval rates are eligible for gold card status. This designation reduces or eliminates prior authorization requirements—decreasing administrative burden for both health plans and labs, improving the provider and member experience, and reinforcing quality compliance.

Avalon provides credentialing support (CLIA, CAP, COLA) and independent, evidence-based reviews of emerging genetic technologies. These reviews inform coverage decisions and accelerate the adoption of valuable new diagnostics.

Leverage Avalon’s deep expertise and provider resources to effectively manage a genetic network on behalf of health plans. Our consultative approach helps our clients develop a cost-effective, member-centric lab network strategy that promotes appropriate utilization and directs members to high-quality labs.

Why participate in Avalon’s preferred genetic network?

For Labs

The AvalonSelect Genetic Network will simplify processes and expedite reimbursement for participating preferred labs.

  • Reduced PA burden with Gold Carding
  • Fast-tracked reimbursement
  • Increased volume as in-network preferred lab provider
  • Assured reimbursement, price, timing and transparency

For Health Plans

Avalon’s extensive lab contracting experience, our evidence-based new test evaluation service, and our preferred genetic network drive access to quality tests while simplifying the complexity and costs of genetic testing.

  • Increased plan savings
  • Simplified administration
  • Improved provider experience and greater consistency in reimbursement expectations
  • Reduced potential for fraud, waste and abuse (FWA)
  • Enhanced provider relationships

Transform your genetic testing management strategy.

Learn more about our Lab Gold Carding program and AvalonSelect Genetic Network

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