CommercialCoverageMedium impact
23-638 Concert Genetics Policies to Replace Applicable Genetic Testing Clinical Policies
Health Net·CA · Oncology, OB-GYN, Cardiology +3 more·Provider News
Effective date
Jun 30, 2023
We identified it
Jun 20, 2026
Summary
HealthNet California is replacing their existing genetic testing clinical policies with Concert Genetics policies, which will be integrated into a new clinical decision support platform called 'Concert Genetics Navigator'. This affects genetic testing coverage and authorization processes for providers in specific California counties.
Action Required
Immediately: Billing teams should access the Concert Genetics Navigator platform for genetic testing authorization decisions instead of using previous HealthNet genetic testing policies. Review the full policy PDF to understand new coverage criteria and documentation requirements for genetic testing claims. Monitor for potential changes in prior authorization processes for genetic testing procedures.