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Patient Billing: What You Should Know

GeneDx believes that genetic testing—and the critical healthcare information it can provide—should be available to all, which is why our billing experts support families to help them access the testing they need.

We accept all commercial insurance, Medicaid, Medicare, and Tricare plans and offer competitive self-pay pricing, no-interest, no-fee payment plans, and a Financial Assistance Program for eligible patients.

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What to Expect from the GeneDx Insurance Billing Process

Step 1

Your healthcare provider will place the test order and GeneDx will likely request a Prior Authorization (PA) approval from your insurance company, unless it is not required. Even though GeneDx is in-network with many commercial health plans, PAs are often required.

Step 2

Your provider may perform a Benefits Investigation (BI). The purpose of a BI is to calculate what you may expect to pay out-of-pocket. It’s important to remember that this is strictly an estimate and is subject to change based on various factors, including the status of the PA.

Step 3

Your final out-of-pocket cost for genetic testing is based on many factors, including the type of test ordered and your health insurance, which determines your copay, coinsurance, and deductible.

It’s great that insurance carriers increasingly cover genetic testing. However, just because insurance covers a test and an individual meets the criteria that their insurance company sets, it does not mean that there will not be a final out-of-pocket cost. If required, this cost will count toward your health plan’s yearly deductible, which is the amount you must pay before your insurance plan begins to pay.

If you have any questions or feel your final bill may need to be revised, please get in touch with our billing team at billing@genedx.com.

How Our Financial Assistance Program Works

Eligible patients* can apply for GeneDx’s Financial Assistance Program (FAP), which may reduce their amount owed. Patients can apply for the FAP before or during the time period that their healthcare provider is placing the test order. If approved, a final bill from GeneDx will reflect the adjusted amount owed.  

How to apply: 

  1. Download and complete the Financial Assistance Application.
  2. Gather the required financial documents (the list of required documents can be found on the application form linked above).  
  3. Fax or email the completed application and documents.
  4. We will contact you regarding approval within 2-3 business days. 

Contact Our Billing Team

We get it: billing can be complicated. GeneDx’s dedicated billing team is committed to making the process quick and easy. We’re here, ready to answer your questions when you need it.  

You can get in touch in two different ways: 

  1. If you have detailed questions, the preferred contact method is to email billing@genedx.com.  
  2. Alternatively, call us at (888) 729-1206, dial option 2, repeat 2.

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