Article | July 2016
Genetic Testing and Counseling Resources
Genetic counseling provides individuals with the opportunity to become fully informed about complex genetic tests.
Who It's For
The
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For a complete, up-to-date list of services that require precertification of coverage, health care providers can log in to
Program Objective
Under Cigna-administered plans, prior to undergoing certain genetic tests, customers are required to get counseling from an independent genetics professional on our
The program is designed to protect your patients and our customers:
- Genetic counseling provides individuals with the opportunity to become fully informed about complex genetic tests and make an informed decision about testing.
- Meeting with an independent genetics professional who is not employed by any clinical or genetic laboratory prevents conflict of interest between the counselor and the facility that performs the tests.
Medical necessity review and prior authorization helps ensure that individuals receive quality and cost-effective care that is covered under their benefit plans.
How It Works
Submit a precertification request form
Submit a precertification request form to determine if the genetic test requires genetic counseling. If genetic counseling is required, please see Step 2.
Refer the patient
Review
Submit the request
The genetic counselor or clinical geneticist typically submits the request, including:
- A completed genetic testing recommendation form, including the test or panel name(s), as well as gene name(s) for a targeted panel
- A three-generation pedigree
- A copy of the ordering health care provider’s laboratory requisition form
- A copy of your genetics evaluation documentation
Please fax the completed form and required copies to Cigna at
Cigna review and decision
We review the precertification request. We understand that many tests, especially the BRCA test, may be urgent. If the precertification request is approved, we will inform the ordering physician. If the precertification request is denied, standard appeal rights will be offered.
Genetic testing and follow-up
The genetics professional can facilitate the blood or specimen collection, genetic testing, and result interpretation. The genetics professional will refer the patient back to the ordering physician for ongoing management, providing them with a consultation report.
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Individual and family medical and dental insurance plans are insured by Cigna Health and Life Insurance Company (CHLIC), Cigna HealthCare of Arizona, Inc., Cigna HealthCare of Illinois, Inc., Cigna HealthCare of Georgia, Inc., Cigna HealthCare of North Carolina, Inc., Cigna HealthCare of South Carolina, Inc., and Cigna HealthCare of Texas, Inc. Group health insurance and health benefit plans are insured or administered by CHLIC, Connecticut General Life Insurance Company (CGLIC), or their affiliates (see
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