Genetic Testing Company | The DNA Diagnostic Experts | GeneDx

Billing

Insurance Billing Policy

Test Insurance Billing policy Patient responsibility Credit card guarantee

Tests on Cardiology, Oncology, Neurology, Prenatal and Exome Sequencing (XomeDx) forms

– All commercial insurance accepted

– Medicare accepted w/ABN

– Medicaid not accepted

GeneDx will bill and carry out appeals as necessary Co-pay, co-insurance and unmet deductible* Not required except for the following: All Blue Cross, Blue Shield and related plans, GHI, Healthnet, State Health Plan of North Carolina, and Teamsters Benefits Trust

XomeDxXpress
XomeDxPrenatal 

Insurance not accepted

Institutionally billed or self-pay Test amount, if not institutionally billed Required, if not institutionally billed
All other tests**

– Most commercial insurance can be billed

– Medicare accepted w/ABN

– Medicaid not accepted

– Tricare not accepted

– California and Maryland HMO plans not accepted

GeneDx will courtesy bill the insurance company Unpaid Balance Required

* Waiver or reduction of co-pay, co-insurance and unmet deductible will be determined based on patient’s financial need.

** GeneDx requires a written letter of pre-authorization in order to bill insurance for these tests. This letter should state that the request for genetic testing for the specific disease/gene has been approved. It is most helpful if the level of reimbursement is also included in the letter. In most cases, an authorization number alone will not be acceptable.

Prices and CPT Codes

Select one of the following links on the Tests Offered menu and open the document indicated:

Document

Select the gene, then open Information Sheet
Select the disease, then open Information Sheet
Select the test, then open Information Sheet
Open Information Sheet
Open Information Sheet

 

   Please click here for 2017 CPT Codes (For price inquiries please email zebras@genedx.com)

 

 

Financial Policy for Institutional Billing

 

  • GeneDx can directly bill a referring institution. To establish an account with us enter your billing information in section one of our payment option form and an account will be automatically established for the institution. If your facility requires a PO Number be used also enter the number on the payment option sheet at the time initial sample is received. This works very well for hospitals/institutions with clinical laboratories and those that have a Send-Out or Referral department. If you have any questions call GeneDx Accounts at 301-519-2100.

 

Prices and CPT Codes

Select one of the following links on the Tests Offered menu and open the document indicated:

Document

Select the gene, then open Information Sheet
Select the disease, then open Information Sheet
Select the test, then open Information Sheet
Open Information Sheet
Open Information Sheett

 

   Please click here for 2017 CPT Codes (For price inquiries please email zebras@genedx.com)

 

 

Financial Policy for International Patients

 

  • Patient Pay: Samples from outside the United States must be accompanied by full payment at the time of sample submission when being paid by patient/family. Payment by check or credit card must be included with sample when patient is paying. If paying by wire transfer, payment must be received before sample arrives or shortly thereafter. A $30 wire transfer fee must be added to cost of test when paying by wire transfer. Payment must be in $US Dollars.
  • Institution Billing: We are able to invoice institutions that are outside of the United States. Payment can be by check, credit card or wire transfer. $30 wire transfer fee must be added to cost of test when paying by wire transfer. Payment must be in $US Dollars.
  • We do not bill international insurance companies.
  • To obtain information for wire transfer, please contact GeneDx by e-mail (genedx@genedx.com) or phone, 301-519-2100.

 

Prices and CPT Codes

Select one of the following links on the Tests Offered menu and open the document indicated:

Document

Select the gene, then open Information Sheet
Select the disease, then open Information Sheet
Select the test, then open Information Sheet
Open Information Sheet
Open Information Sheet

 

 

   Please click here for 2017 CPT Codes (For price inquiries please email zebras@genedx.com)

 

Prepayment at the time of sample submission can be achieved by:

 

  • Check or money order, payable to GeneDx, Inc. for the quoted full cost of the test
  • Check or money order, payable to GeneDx, Inc. for 75% of the quoted cost of the test. The remainder will be billed at completion of the test prior to reporting of results.
  • Charge to Visa, Mastercard, Discover, or American Express for the full quoted cost of the test at the time of sample submission. Credit card payments will not be split.

 

Prices and CPT Codes

Select one of the following links on the Tests Offered menu and open the document indicated:

Document

Select the gene, then open Information Sheet
Select the disease, then open Information Sheet
Select the test, then open Information Sheet
Open Information Sheet
Open Information Sheet

 

 

   Please click here for 2017 CPT Codes (For price inquiries please email zebras@genedx.com)
 

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