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 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 will be limited to $500	Not required
GenomeDx: whole genome array CGH 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	Not 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

* 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.