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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.