Most insurance carriers cover genetic testing services for hereditary cancer. In fact, although each situation is unique, the average patient pays a coinsurance of less than $295. Myriad assists in obtaining the best possible reimbursement for each of the genetic tests we offer. Our goal is to ensure that your patients receive the appropriate coverage from their plan.
There are several payment options available:
Option 1 – Insurance Billing
If the Insurance Billing option is selected on the Test Request Form, Myriad will verify coverage and determine the patient’s financial responsibility.
Myriad offers financial assistance to reduce out-of-pocket costs for qualified underinsured patients in the U.S. to no more than $295. Examples of patients who are considered underinsured include:
- Those with a high deductible or out-of-pocket expenses
To be eligible, patients must have private insurance, meet the medical criteria for testing, and meet low income requirements (household incomes up to 400 percent of the Federal poverty level). This expansion of Myriad’s financial assistance program to underinsured patients complements the free testing Myriad currently offers for low income uninsured patients.
Myriad offers testing at no charge to uninsured patients that meet medical criteria and the low income requirements (household incomes up to 400 percent of the Federal poverty level). Due to regulatory limitations, patients who are recipients of government funded programs (ie, Medicaid, Medicare, Medicare-Advantage, and Tricare) are not eligible to apply for MFAP.
Note: Some insurers may require a pre-authorization before the sample is initiated, which may delay the start of the test. We will notify your office if this is the case.
In order to proceed with the Insurance Billing option, the Patient/Responsible Party signature on the Test Request Form and enlarged photocopies of the front and back of the patient’s health insurance card(s) are required. Myriad will submit bills directly to the patient’s insurance carrier and will also appeal and resubmit claims on the patient’s behalf, with input from you as the authorized healthcare provider as needed.
Myriad Financial Assistance Program – If a patient encounters ANY financial hardship associated with their bill, Myriad will work directly with the patient toward their complete satisfaction, GUARANTEED.
Option 2 – Patient Payment
The patient has an option to self-pay for testing. Patients may provide credit card information on the Test Request Form, provide a check or money order payable to Myriad Genetic Laboratories, Inc. for testing services. Myriad also offers interest free payment plans. Please have the patient call Myriad Customer Service at 800-469-7423 for payment information.
Option 3 – Other Billing (Bill Institution/Research/MGA)
The Bill Institution option should be selected if the facility would like to be billed for the test charges. Please provide your Bill Institution account number on the test request form. If you do not have a Bill Institution account number, please submit billing information with specimen including: name of institution, responsible party name, billing address, phone and fax.
The research project code should be specified on the Test Request Form only if the facility has a current research project with Myriad Genetic Laboratories.
Myriad Genetics Authorization (MGA):
The MGA option should be marked if Myriad has authorized research testing for this particular patient. Please make sure that MGA number is provided on the test request form, and the relationship to the known mutation carrier is specified.
Should the patient have any questions regarding billing questions after the test is complete, the patient is encouraged to contact our Billing Department at 800-725-2722.
Qualification requirements and the submission instructions are provided below:
- Myriad Financial Assistance Application
- Solicitud del Programa de Asistencia Financiera Myriad
- Medical Criteria
- Financial Criteria
To view the current HHS financial guidelines, please view the link below. http://aspe.hhs.gov/poverty/index.shtmlView the Provider Billing Guide