Billing: Our Best Kept Secret
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Billing for reimbursement of genetic testing in today's healthcare environment is complicated. At PreventionGenetics, we believe in the power of genetic testing and strive to make the testing process as transparent and straightforward as possible. Below are some facts about PreventionGenetics' billing policies and services, and what they mean for you.
Transparent Prices - Our test prices are openly published on our website. We charge the same price regardless of payer type.
What this means - Simple, ethical billing practices with no unexpected charges.
Investigation of Benefits - Upon request, we will contact any commercial insurance payer for an investigation of benefits for your patient. Our billing team handles pre-verifications promptly and professionally and follows-up with the insurance company to ensure a quick response. We provide a written quote of benefits (QOB) typically within 24 to 48 hours to you and/or your patient for all pre-verification requests. If we learn that Pre-Authorization is required, we will submit all required information and report the outcome to you. At your request, we can also work directly with the patient. This service is available either before or after the patient's specimen is sent to us. There are no charges if the patient decides to cancel testing because of out of pocket expenses.
What this means - We will do the insurance work for you. Simply complete our benefit investigation request form, and we'll do the rest. We'll also let you or the patient know the details in writing, including max out of pocket costs regardless of the amount. No billing surprises. No cancellation fees.
Insurance Claim Filing - We will file an insurance claim with any commercial insurance company on behalf of your patient if insurance billing is selected on the test requisition form.
What this means - Once testing is complete, we will file an insurance claim. We follow-up promptly with the insurance company to ensure all information is filed and the claim is closed in a timely fashion. We keep the patient informed of the status of their insurance claim through a monthly statement.
Interest-Free Payment Plans - We offer interest-free payment plans for the balance due from the patient.
What this means - To help your patients get the test they need, no payment is required upfront. We are flexible and work with them to establish a payment plan that fits their situation without any finance charges or other surprise fees.
Financial Hardship Program - We believe cost should not be a deterrent for receiving valuable genetic information. In order to accomplish this goal, we have set aside funds to distribute among patients in need of financial assistance. We work with providers and patients to allocate funds on a case by case basis, in a manner that maximizes the benefit for as many patients as possible.
What this means - On a case by case basis we can help patients with financial hardships. There are no application forms or hassles, just a conversation with our team.
Commitment to Utilization Management (UM) - Our entire team is committed to making sure that the most appropriate and cost effective test is performed. Multiple review steps are in place to maximize UM.
What this means - Healthcare savings that are passed on to patients. We will always do our best to make sure that patients receive only the testing they need. To read a few recent UM case examples where we saved thousands of healthcare dollars, click here.
Customizable Test Menu - We offer flexible testing options including reflex testing, targeted testing, panel testing and will soon have a tool for building custom panels. If you don't see what you need on our test menu, contact our Client Services Team (support@preventiongenetics.com) and we may be able to create a custom option to fit your needs.
What this means - Testing options fit your patients' needs rather than making your patients fit available tests.
Discounted DNA Banking - DNA banking is available for a one time fee of $169. Patients who have testing performed at PreventionGenetics can bank their DNA for a discounted rate.
What this means - Patients can store their DNA at PreventionGenetics for any future or additional testing at a low one-time fee.