Lab Benefit Management (LBM) combines test registry, test identification, network, benefit, policy and prior-authorization services with automated policy enforcement to integrate disparate offerings and create a new standard in genetic testing policy.
To accomplish these goals, Optum partnered with Avalon Healthcare Solutions, a leading lab benefit management organization. Avalon's ability to provide proprietary evidence-based lab policies, a pre-service review program administered by physicians, nurses and geneticists, and technology supporting policy adherence comes together in a solution that compliments Optum's test identification and assessment processes, streamlined administrative model, and ability to integrate and scale. The Avalon - Optum partnership supports multiple clients under this new working model.
Product overview
LBMs enable access to their own curated independent lab networks or support health plans to create stronger network relationships with their provider and laboratory networks. LBMs work with health plans to determine network policies and coverage requirements, including payment rates for routine laboratory tests, genetic, and molecular testing, provide utilization review and prior authorization services including claim reviews.
How to try an API?
| Release notes | FAQs |
|---|---|
| View our Release notes for more information. | Check out our FAQs for help with your questions. |