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Option 1— Insurance Billing
For patients who choose Insurance Billing on the Test Request Form,
Myriad will verify coverage and determine patient responsibility.
If the patient’s coinsurance responsibility will exceed $375, prior
to processing their specimen, we will contact the patient directly
within three business days after sample receipt at Myriad to discuss
the specifics of their case and options available to them. If coinsurance
is NOT expected to exceed $375, the patient is not contacted and their
specimen processing begins immediately.
Note: Although rare, some insurers may require a pre-authorization
before the sample is submitted for testing, which may delay the start
of the test. We will contact the healthcare provider if this is the case.
Patients must sign the Insurance Billing Patient/Responsible Party signature
line on the Test Request Form and submit enlarged photocopies of the front
and back of the their insurance card. Myriad will submit bills directly to
insurance carriers and will appeal and resubmit claims on the patient’s behalf,
with input from the patient’s authorized healthcare provider as needed.
Coinsurance and unmet deductibles are the patient’s responsibility.
Option 2 — Patient Payment
Patient pays for the testing service themselves. The patient may make this selection
and provide credit card information on the Test Request Form or provide a check
or money order payable to Myriad Genetic Laboratories, Inc. for the full amount
of the test, which should be submitted with the Test Request Form. A patient may
also contact Customer Service for installment payment options.
Canceling the Test
If you cancel a test before it is started, you will not be charged. Most tests are
stared within 24-48 hours after receipt at Myriad. Once your test is started, you
are responsible for payment of the test.
Medicare
Medicare pays for the test when specific criteria are met. Physicians should consult
Medicare's web site to determine if the patient meets Medicare's testing criteria
for genetic testing, and can obtain assistance in interpreting the criteria from
Myriad's Medical Services 800-469-7423, option "2." For all Medicare patients,
a copy of the signed Informed Consent From is required before testing will begin.
For patients who do not meet Medicare criteria, an Advance Beneficiary Notice (ABN)
is also required before testing will begin. Because Medicare will likely not cover
test costs for patients who do not meet Medicare criteria, test costs will be
billed to the patient. A summary of instructions and documentation requirements for
Medicare patients is included on page one of the Advance Beneficiary Notice.
Myriad Financial Assistance Program
Myriad is able to offer testing at no charge to uninsured patients that meet specific
financial and medical criteria. Patients who are recipients of government-funded
programs (i.e. Medicaid, Medicare) or those that have any third-party insurance
are not eligible to apply.
Qualification requirements and the submission instructions are provided on the
Myriad Financial Assistance Program application:
To view the current HHS financial guidelines, please view the link below.
http://aspe.hhs.gov/poverty/index.shtml
Letters of Medical Necessity (LMN)
In the event an insurance company requires that a separate letter of medical necessity
(LMN) be submitted, Myriad has included some guidelines for writing LMNs and example
LMNs can be viewed by clicking the following links.
* PDF forms require the free Adobe Acrobat Reader software. |
