Use Clear Coverage to Enter Diagnoses for Molecular Diagnostic and Genetic Tests for HMO/POS Members

Starting this fall 2013, BCBSMA will ask ordering clinicians and testing laboratories to use McKesson’s online Clear Coverage application to supply data for genetic tests and molecular diagnostic services. This data will help develop appropriate prior authorization requirements for these services. Clinicians will be asked to enter only the test name and diagnosis into McKesson’s Clear Coverage web-based tool for HMO and POS members only. After BCBSMA has analyzed the data, anticipated in 2014, they’ll work with clinical experts to determine which molecular diagnostic and genetic tests will require utilization review and prior authorization. You will receive advance notice about these requirements and training on the Clear Coverage tools.

Source: https://www.bluecrossma.com/portal/dt?provider=providercontent&usecaseid=CP29&newsCategoryName=Provider%20Focus&rightnav=no