UC Irvine

Clinical genetic testing has incredible promise due to its clinical utility and proven cost effectiveness when ordered and performed appropriately. However, the relationships amongst healthcare providers, insurance companies, and genetic testing laboratories are complicated and evolving quickly. In the field of clinical genetics, the responsibility of coordinating billing for genetic testing often falls on the genetic counselor—a person who usually does not have formal training in this area. Having a person who is not formally trained in insurance and billing coordinating this aspect of the process may be reducing productivity or quality of care. With this study, we surveyed clinical genetic counselors to evaluate trends in their interactions with insurance companies and their confidence in how they manage insurance and billing. We also included in the survey questions about training that the participants received. Free-response questions about health insurance terms were included to determine the level of understanding of health insurance. The survey responses were analyzed based on demographic factors and data about clinical practice, including subspecialty and other professional and institutional characteristics. The results of the study demonstrated that training provided in graduate school and by employers was significantly correlated with preparedness and confidence level in the insurance and billing processes. Additionally, respondents’ decision making with respect to insurance and billing in clinical scenarios was correlated with certain institutional and professional characteristics. This study highlights the importance of the relationship between genetic counselors and health insurance and underscores the need to educate genetic counselors about insurance and billing.