Cardiology Genetics Billing Policy

Payer	Policy
Commercial Insurance	GeneDx accepts all commercial insurance policies. Please be sure to send us complete insurance information, and include a copy of the front and back of the insurance card. GeneDx will bill insurance, and conduct the appeal process as necessary until all options are exhausted. A patient will be responsible for any co-pay, co-insurance and unmet deductible amounts that their policy dictates. Patient's out-of-pocket cost can range from $0 to $100* per test based on the unmet deductible. Credit card information is required for all Blue Cross, Blue Shield and related plans, GHI, Healthnet, State Health Plan of North Carolina and Teamsters Benefit Trust. If the patient does not provide credit card information with the test requisition, GeneDx will contact the patient before beginning the test. For more information regarding commercial insurance billing at GeneDx, please call us at 301-519-2100 X 6727. GeneDx cannot bill insurance for the Sudden Unexplained Death panel because testing on deceased persons is not generally covered by third party payors. GeneDx offers a compassionate price of $2,500 for this test, with payment by check or credit card expected at the time the sample is submitted. Please contact the lab at 301-519-2100 if you have any questions.
Institutional bill	GeneDx can bill a referring institution directly if an Institutional Account with GeneDx has been established. This allows the referring physician to submit samples through their facility’s send out laboratory. Establishment of an institutional account is very simple and requires only a phone call from the laboratory administrator to Dr. Sherri Bale at 301-519-2100, x 6102.
Self-Pay	GeneDx provides discounted pricing for self-pay patients. For more information, please call us at 301-519-2100, X 6106.
Medicare	GeneDx is currently not a Medicare provider and therefore not able to accept Medicare patient samples.
Medicaid	GeneDx is currently not a Medicaid provider and therefore not able to accept Medicaid patient samples.

* Except in Florida and Colorado, where the waiver or reduction of co-pay, co-insurance and unmet deductible will be determined based on patient’s financial need.

If you have questions regarding commercial insurance billing at GeneDx, please do not hesitate to call us at 301-519-2100 x 6727. For all other billing questions, please call 301-519-2100 x 6106.

Family member testing: GeneDx also offers mutation testing for family members of any patient who has been identified previously by GeneDx to have a gene mutation. For more information, please call one of our genetic counselors at 301-519-2100.