About the program

The Point32Health Molecular Diagnostics Management program addresses the complexities of molecular diagnostics by supporting evidence-based genetic testing at in-network laboratories. Your participation is required when recommending molecular diagnostics for Point32Health members. We review each test you request and the clinical information you submit to ensure the request aligns with Carelon Medical Benefits Management evidence-based clinical guidelines. 
If clinical criteria are met, and an in-network laboratory is selected, your request is approved. If a request cannot be approved at intake, personnel from our contact center are available to support rapid resolution of your request.

Benefits of participating

• 24/7 online access to the Carelon provider portal, a proven technology platform to process review requests in real time
• Synchronization with health plan medical policy
• Access to a database of providers available to perform genetic counseling when required, including local providers and providers of telephonic counseling services
• Assurance that your practice is providing evidence-based care
• Protection from unnecessary out-of-pocket costs for your patients