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For Physicians

Q: Is using CMT Solutions for prior authorizations HIPAA compliant?

A: Yes, enrolling with CMT for prior authorizations is HIPAA compliant. A Business Associate Agreement (BAA) is required at enrollment to establish a relationship with a HIPAA covered entity (e.g. a clinician’s practice) to ensure the security of the covered entity’s data assets. Prior authorization servicing requires access to Protected Health Information (PHI) and having a BAA with CMT Solutions helps ensure security and overall HIPAA compliance.

Q: How will enrolling with CMT Solutions change our Prior Authorizations process?

A: Enrolling with CMT Solutions will take the burden off of your office from having to process the prior authorizations for genetic laboratory testing. The enrollment process requires three basic steps for a clinician office:

  1. Complete the online enrollment form at covermytest.com
  2. Complete the CMT HIPAA Business Associate Agreement and Provider Authorization Agreement
  3. Provide the necessary payor credentials to CMT.

Once the enrollment process is completed no additional action is needed. Your office will conduct business as usual, focusing on your patient’s care, and prior authorization servicing with CMT Solutions will be working on your behalf.

Q: Can I enroll as a practice  or will I have to enroll each provider individually?

A: CMT Solutions can enroll entire practices and will capture all the providers who order genetic testing under each practice. We will look to capture the NPI of each physician, NP/PA, Genetic counselor and that can be stored under an overall clinic name.

Q: How will enrolling in CMT Solutions change the ordering process?

A: Enrolling with CMT Solutions will not change the workflow of how your order or receive the results of genetic testing from your chosen laboratory. You will continue to send the requisition and samples to the laboratory, and from there, the laboratory will coordinate with CMT Solutions for the prior authorization. You can also see the status of the prior authorization by logging into the CMT portal at any point in the prior authorization process.

For Laboratories

Q: What is CMT Solutions?

A: CMT Solutions is a healthcare services company that has developed a proprietary technology solution that provides prior authorization support and comprehensive services that helps reduce barriers to access, so that you can focus on your patient’s care.
Q: How will enrolling in CMT Solutions change the ordering process?
A: CMT Solutions has the ability to work with almost all payors such as UnitedHeathCare, BCBS,  CareFirst, and laboratory benefit managers (LBMs) such as AIM, Beacon, Evicore, Availity, and Avalon. Your CMT Solutions account representative can give you the specific payors that require prior authorizations for genetic testing.

Q: What tests do CMT Solutions perform the PA for?

A: CMT Solutions has the ability to perform PA for complex genetic testing. We have expertise in Prenatal, Hereditary Cancer, Oncology, Thyroid, and Mental Health. We also perform the prior authorizations for rare genetic testing with our expertly trained specialist team.

Q: How do you handle the flow of information from our laboratory to the CMT Solutions platform?

A: We can securely handle the flow of information from your laboratory into our proprietary platform in many different ways. The CMT and Laboratory IT teams will decide on a file transfer method, from the following:

  • CSV File to include Box or SFTP
  • API
  • Input directly from the lab into the CMT portal