Healthcare Provider Billing

Excellent Coverage, Personalized Support

At Ambry, we believe every patient should consistently have access to high quality testing and the confidence to know cost will not be a barrier, regardless of their personal situation.

There is no 'one-size-fits-all' in healthcare, therefore we will consider each patient’s individual cost concerns so you don’t have to.

Ambry’s Every Patient Individually Considered (E.P.I.C.) philosophy aims to make genetic testing affordable for all patients. Patients can elect to be considered by providing the requested financial information at the bottom of the Test Requisition Form (TRF). Our team of trained billing specialists will contact you or your patients if further information is needed.

Click here for more information on Ambry's E.P.I.C. program.

Insurance billing

Our Pre-verification department can verify insurance coverage and provide you with details about each patient’s individual coverage for genetic testing. To take advantage of this service and get an estimate of your patient’s Out Of Pocket (OOP) cost, please submit the form below.

Please click here to complete the pre-verification form and the appropriate Ambry representative will contact you shortly.

We are contracted with the majority of U.S. health insurance plans, including many of the plans provided by*:

  • Aetna
  • BlueCross BlueShield
  • Cigna
  • Humana
  • Kaiser Permanente
  • Medicare
    • We are a certified Medicare provider. The patient must meet Medicare’s specific testing criteria for genetic tests. If the patient does not meet the criteria, a completed Advance Beneficiary Notice (ABN) is required.
    • Our Pre-verification department can verify insurance coverage and provide you with details about each patient’s individual coverage for genetic testing.
    • Medicare does not currently cover any genetic tests meant to screen patients who have never had an associated cancer diagnosis.
    • We are not able to bill Medicare if the patient is unaffected and genetic testing is being ordered based only on family history.
  • UnitedHealthCare

*Coverage may vary by individual plan.

Self-Pay

For all customers without insurance, we offer competitive self-pay pricing. Ambry’s E.P.I.C. philosophy means, we consider each patient’s personal situation as soon as the sample is received, and take steps to make sure all patients are aware of the associated cost of testing.

With either insurance or self-pay, if your patient believes that Ambry has not considered all relevant factors in determining his or her out-of-pocket cost, he or she may complete and submit an OOP dispute form, found here.

Have your patients call or email our Billing Department at +1-949-900-5795 or billing@ambrygen.com with any questions.

Checks & Money Orders

Please make checks and money orders payable to Ambry Genetics. There is a $25.00 processing fee for returned check payments.

Credit Card Payments

Approved credit card (AMEX, Discover, MasterCard, or Visa) payments are accepted. The card type, cardholder name and signature, credit card account number, expiration date, and contact phone number must be provided.

Wire Transfers

Payments can be made via wire transfer from your bank. Please contact us for more information.

Cancellation requests are honored only if the test order is canceled by contacting an Ambry Client Services Representative (toll-free 866-262-7943) before the sample is received/accessioned. If the sample has been received/accessioned, a fee of $75.00 may be billed to the patient.

Test Cancellation Policy

Once the sample enters into the reporting process, the client or insurance carrier will be billed the full amount of the test requested and normal patient reporting will occur.

Special Note: If a panel was ordered that contained reflexive steps and only part of the tests were batched, only those tests that have entered the reporting process will be billed in full. The remaining tests will be canceled and not billed.

Insurance Lists by Region

Ambry Genetics is contracted with numerous health plans and institutions. Although specific plans and geographic coverage may vary, Ambry is committed to making the genetic testing process as simple and cost-effective as possible. If you have a question on a specific plan, please contact our Insurance Preverification Team by filling out this form or calling at (949) 900-5794.

Below are links to lists of our contracted health plans by region:

International Billing

Ambry Genetics works with international clients to make paying for your genetic solutions simple. For your convenience, we have outlined the policies and procedures for international billing below.

Please Contact Us if you need assistance.

Institutional Billing

Ambry is open to working with any institution to set up a direct billing account. Since 1999, Ambry has offered healthcare providers cost-effective, clinically-relevant testing solutions for the patients they serve. For more information about setting up an institutional account, click here.

International Institutional Billing

International samples must be prepaid unless the institution has already established an account prior to sample submission. An e-mail address is required to establish an international institutional account. The account ID will be communicated by e-mail once the payment information is verified and all required information is received.

If no account has been established, please submit a check, money order, credit card number, or wire transfer payment with samples.

Send-outs Consolidation

Why send out to multiple labs when you can send out to just one? Ambry Genetics has a comprehensive menu of more than 300 tests that allows our clients to avoid sending samples to numerous locations, which in turn immediately lowers laboratory operating budgets. 

Benefits of using the Ambry Genetics' Consolidation Program:

  • Expertise in applying new technology to diagnose genetic diseases
  • Comprehensive menu of 300+ tests that allows clients to eliminate sending tests to numerous labs
  • Flexible billing options
  • Custom panel development

Below are Ambry’s Genetic Testing Consolidation Components:

  • Genetic testing send-outs assessment
  • Testing consolidation cost savings analysis
  • Strategic integration planning
  • Institutional discounts
  • Insurance billing solutions
  • Client Services support
  • Implementation Meeting
  • Educational assistance
  • Sales & marketing collaborations
  • Sales training
  • Co-branded marketing material
  • Quarterly post implementation meetings and audits

Hospitals and reference labs that have chosen to consolidate testing with Ambry have not only seen a decrease in operating costs, but improved results reporting and quicker turnaround times. To get started today, please contact us.

UnitedHealthcare’s Genetic Testing Authorization Program

Effective November 1st, UnitedHealthcare will require clinicians to sign up for a proprietary portal to order genetic testing for patients covered by their insurance

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