- HIGHMARK
Effective 5/1/2013
- BCBS of Arizona
Effective 4/10/2013
- Capital Blue Cross of Pennsylvania
Effective 3/26/2013
- BCBS of New Hampshire
Effective 3/21/2013
- BCBS of Minnesota
Effective 3/19/201
- BCBS of Louisiana
Effective 4/19/2013
Billing & Insurance Information
Ambry Genetics works with all of our clients to facilitate easy and convenient billing. Please click the links below to learn more.
Ambry Genetics offers to bill insurance carriers directly and accepts the amount of coverage of the test cost assigned by the insurance company. For all 'insurance-bill' samples that are submitted, Ambry will pre-verify patient insurance coverage. If the estimated patient out-of-pocket costs for co-pay, co-insurance, and/or deductible is greater than $300 (does not apply to Medicare and Medicaid), Ambry will notify the patient. If you would like us to call your patient regardless of the total out-of-pocket costs, please state this on the Ambry test requisition form. By law, patients are responsible for co-pay, co-insurance and unmet deductibles; thus, your patient will be required to pay for these amounts. In addition, when applicable, your patient will be responsible for paying any charges for services determined to be not medically necessary by the insurance carrier.
Client Price List (Last updated 05.23.2013)
2013 Price List Sort by Test Code
2013 Price List Sort by Test Name
Due to the dynamic environment we are experiencing with 2013 CPT codes (MoPath Codes), we are making our price list and MoPath codes readily available to you. We will update frequently. Please, check back routinely for the most current client price list.
CPT Codes
View the CPT codes with units to assist in the prior-authorization and billing process.
Learn how to consolidate your send-out tests with Ambry and immediately lower your laboratory operating budgets.
Institutional Billing
Obtain information about setting up an institutional account.
Insurance Billing & Insurance Preverification Requests
Obtain information for billing patients with insurance coverage/preverfication request form to have us verify insurance coverage and share of cost. Please allow up 72 business hours for a response. (Due to recent high volume we are experiencing delays.)
Obtain information for billing patients with insurance coverage/preverfication request form to have us verify insurance coverage and share of cost. Please allow up 72 business hours for a response. (Due to recent high volume we are experiencing delays.)
Medicare & Medicaid
See our Medicare provider information and the Medicaid states we are contracted with. Front and back copy of insurance card and insurance authorization must be included. A completed Advance Beneficiary Notice (ABN) is required for Medicare patients. Call our Billing Department to check status of states not listed.
Self Pay
Obtain information for patients who will be paying for testing out-of-pocket (due to no insurance or other coverage).
International
Obtain information for clients sending in samples from outside the U.S.
Definitions:
- Authorization – An approval to perform testing by the insurance company
- Preverification – A service Ambry provides to our clients to obtain benefit information (out of pocket costs) and coordinate authorization requirements.
- Insurance Verification Representative – An Ambry employee who is specialized in obtaining insurance benefits and approvals.
- OOP – Out of Pocket Costs to the patient
- ABN – Advanced Beneficiary Notice
- LOA – Letter of Agreement
- LMN – Letter of Medical Necessity
- Payer – Insurance Company
- Carrier – Insurance Company