Neurology Genetics Billing Policy
GeneDx accepts all commercial insurance policies. The patient is responsible for only the co-pay, co-insurance and unmet deductible dictated by his or her insurance carrier. GeneDx will perform a benefit investigation and attempt to contact the patient if the patient’s out-of-pocket cost is expected to be greater than $100. GeneDx will review the information and discuss payment plan options. A Financial Assistance Program is available to patients with financial difficulties. If the patient decides to cancel the test, we will contact the physician that ordered the test to get their approval before cancellation. GeneDx provides a compassionate care price as well as a payment plan for patients who are financially challenged. If the patient receives a payment from the insurance company, it is patient’s responsibility to pay GeneDx within 10 days of receipt of that payment. This payment is not eligible for reduction under any financial assistance or compassionate care program. For more information regarding commercial insurance billing at GeneDx, please call us at 888-729-1206.
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 our billing department at 888-729-1206.
GeneDx provides discounted pricing for self-pay patients. For more information, please call us at 888-729-1206.
GeneDx is a Medicare provider and therefore is able to accept Medicare patient samples. A completed Advance Beneficiary Notice (ABN)
is required for Medicare patients.
GeneDx is a registered provider with several Medicaid plans. Although we are a registered provider with these plans, prior authorization is required for Medicaid samples and must be obtained by the ordering physicians office. In an instance where we receive a Medicaid sample without a prior authorization, the test will go on hold and not proceed in the lab. In most cases, Medicaid will not cover genetic testing for these conditions, as Medicaid coverage varies by state.
If you have questions regarding billing at GeneDx, please do not hesitate to call us at 888-729-1206. 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 888-729-1206.
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