The CDL can bill the laboratory submitting the specimen, the patient’s insurance (including Medicaid), or the patient. For questions on billing, please first consult our Billing FAQ’s page.
To bill INSTITUTION
-The CDL will bill the referring institution for the entire cost of the test ordered.
-Invoices are generated upon completion of testing.
-Payment terms are Net 30 from the date of invoice.
-Payment may be made by an institution check, money order or by Visa or MasterCard credit card as instructed on the invoice.
To bill PATIENT INSURANCE
-All information in the “Insurance Billing” section of the CDL Laboratory Test Requisition Form must be completed.
-A clear copy of both the front and back of the patient’s insurance card must be submitted with the Requisition Form and specimen.
-It is required that pre-authorization be obtained from the insurance company before testing is initiated (either by the Provider or the CPDx, see below). If the Provider obtains pre-authorization the CPDx will not also confirm coverage or denial.
As a courtesy to patients, the CPDx offers help with obtaining insurance pre-authorization for laboratory tests priced over $500. Our protocol is that we will not pre-authorize unless we have a sample in the lab. We have had to request this because we found after pre-auth was obtained some physicians used the approval elsewhere or never submitted a sample. We will hold DNA at no cost until the pre-auth is approved or denied.
Patients should understand that insurance may not cover all costs of genetic testing and they may be financially responsible for some or all of the cost of testing. The patient is responsible for any portion of the testing charge not covered by their insurance company for any reason including co-payments, co-insurance, unmet deductibles, or non-covered services. This may be true even if prior authorization was obtained since prior authorization does not guarantee payment by the insurance company.
Steps to take to request preauthorization can be found on the pre-authorization information sheet . Please note, Medicare does not preauthorize.
Please complete and submit the CPDx Insurance Preauthorization Form and the CDL Laboratory Test Requisition Form with the patient sample to request assistance. Contact Sheryle with any insurance questions at (206) 221-1274 (firstname.lastname@example.org).
To bill MEDICAID
For Medicaid billing, please include:
- A pre-authorization letter from Medicaid, with the effective dates of coverage
- Medicaid claims address
- Copy of Card
- Letter of necessity from referring physician
To bill MEDICARE
For Medicare Billing, please include:
- Copy of Card
- Completed MEDICARE ABN FORM (required as genetic testing may not be a covered service)
To bill PATIENT
Patients may pay for tests using a credit card, money order, or personal check submitted with the Requisition Form and specimen. For international orders, all payments must be in U.S. dollars.
Pre-payment for international samples is required. Click HERE for a wire transfer payment instructions.
For Canadian samples: Please note that providers must acquire approval of all tests, including any possible reflex testing, before submitting samples.