Verifying insurance coverage requirements or obtaining preauthorization is recommended and often necessary PRIOR TO SPECIMEN COLLECTION. Some insurance carriers may allow a request for preauthorization to be submitted on the day of specimen collection for certain testing.
- The ideal time to submit orders for testing and a patient specimen is after preauthorization is requested and eligibility of coverage is determined.
- To avoid delays in specimen processing and resulting, we do NOT recommend submitting a specimen before insurance coverage is determined; however, for non-stat molecular testing, if a specimen and orders for testing are submitted and insurance authorization is also requested, DNA will be extracted and testing will not proceed until consent is received from the ordering provider and/or patient. Testing automatically proceeds if the out of pocket estimate is $100 or less (not applicable to hereditary cancer testing).
We offer courtesy preauthorization services to simplify this process for our clients.
- Complete and submit a insurance preauthorization request form, which gathers information required by insurance carriers to determine eligibility of coverage for genetic testing. Provide as much information as possible.
- Include a legible copy of the front AND back of the patient’s insurance card.
- Submit to us by email at firstname.lastname@example.org or fax at 402-559-7248 and let our client service experts take it from there.
What to expect after a request has been submitted
- A confirmation that your request has been received (by the method designated in section D of the preauthorization information form).
- Response from the insurance carrier is generally received within 14 days. An 'Insurance Authorization Update' will be sent in nearly all situations to the ordering provider (by the method designated in section D of the preauthorization information form) and to the patient (by postal mail or email).
- Testing will automatically proceed if the out of pocket estimate is $100 or less (not applicable to hereditary cancer testing). Otherwise, we need verbal or written notice from the provider or patient to proceed. Only when specimens are submitted with a test order in addition to a request for insurance authorization do we contact the patient by phone to discuss insurance determination and obtain consent to proceed with testing. All authorization requests for hereditary cancer testing will result in the patient being contacted.
- The provider is responsible for coordinating specimen collection and shipment to our laboratory. Though not required, tests collection kits are available upon request by contacting our client services team by email or phone 402-559-5070.
Adobe Acrobat Reader is necessary to view/print forms. Download Adobe Reader