CytoGenX will bill commercial insurance carriers directly if complete and accurate information is provided on the test requisition form.
Hospital and Medical Laboratory Billing
We will bill a referring institution directly upon request in accordance with applicable government regulations.
As a service to our patients, CytoGenX will bill all insurance carriers directly when all of the necessary insurance information is provided.
If a patient has an insurance carrier contracted with CytoGenX
We will accept 100% of the contracted price for a test. We will bill the patient according to the explanation of benefits (EOB) issued by the patient’s insurance carrier. If the health plan instructs us to bill for co-pays, co-insurance, deductibles, and non-covered services then we are required by law to bill accordingly.
If the patient has an insurance carrier that is not contracted with CytoGenX
We will bill the patient’s insurance carrier. If the particular carrier does not pay 100% of our charge(s) for the testing, we will attempt an appeal to the carrier for payment of services on behalf of the patient. If the health plan instructs us to bill for co-pays, co-insurance, deductibles, and non-covered services then we are required by law to bill accordingly.
The patient will be contacted for complete and accurate insurance information, if we are not provided with complete or correct billing information. If there is no response from the health plan after a reasonable length of time, we may also bill patient for the services rendered.
Coverage and Medical Necessity
Some insurance carriers cover only those laboratory tests that are reasonable and necessary for the diagnosis or treatment of an illness. They may not cover “rule out” or routine screening tests.
We may waive or adjust charges only after determining in good faith that a patient is in financial need or is indigent, and/or after we have made reasonable collection efforts. At CytoGenX these decisions are made on a case-by-case basis.
PO BOX 339
Stony Brook, NY 11790
Telephone: (888) 436-3633