GeneDx Insurance Billing Policy

GeneDx does not participate in any insurance plans at this time and will be billing as an “out-of-network” service provider. To bill insurance, a photocopy of the front and back of the patient's insurance card must accompany the patient sample.

Test	Insurance	Billing policy	Patient responsibility	Credit card guarantee
Cardiology: HCM, DCM, LQTS, Brugada syndrome, ARVC, CPVT panels All Neurology Tests GenomeDx: whole genome array CGH	- All commercial insurance accepted - Medicare not accepted - Medicaid not accepted	GeneDx will bill and carry out appeals as necessary	Co-pay, co-insurance and unmet deductible, which can range from $0 to $100*	Required for all Blue Cross, Blue Shield and related plans, GHI, Healthnet, State Health Plan of North Carolina and Teamsters Benefit Trust
Prenatal array CGH Prenatal Noonan Panel	- All commercial insurance accepted - Medicare not accepted - Medicaid not accepted	GeneDx will bill and carry out appeals as necessary	Co-pay, co-insurance and unmet deductible	Required
All other tests**	- Most commercial insurance can be billed - Medicare not accepted - Medicaid not accepted - Tricare not accepted - California and Maryland HMO plans not accepted	GeneDx will courtesy bill the insurance company	Unpaid Balance	Required

*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.

** 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.