Routine Test Management Program is Live February 6

We announced in November that the Routine Test Management (RTM) program starts February 6. It targets specific lab services, tests, and procedures commonly ordered in routine care.

Why it Matters

Routine test management assures compliance through automated claim reviews for selected lab tests. This includes office, hospital outpatient, and independent lab settings.

What to Do

• Exclude emergency and inpatient labs: Emergency room, hospital observation, and inpatient lab services are not part of RTM.
• Look for the laboratory management trial claim tool in Availity Essentials: Simulate a claim within the resources tab in the LifeWise Health Plan of Washington payer space (Clark County only).
  • Enter service codes and diagnoses to check coverage before submission.
  • This is a simulation tool that does not guarantee approval or reimbursement.
• Review RTM policies: Reference medical policy and coding updates and payment policy updates.