Insurance Billing & Insurance Preverification Request

We require that all insurance cases come with a completed Test Requisition Form, including ICD-10 codes. HMO authorizations or referrals should be attached.

Please send a copy of the front and back of your patient’s insurance card for both primary and secondary insurance carriers. If the card is not available, a copy of your patient's demographic information, or their clinic registration and billing form, should be submitted.

Ambry Genetics will verify status of benefits for all insurance samples before processing. All tests not authorized by the patient’s insurance will be the responsibility of the patient.

Insurance Preverification Requests

The first step is to complete a Preverification of Benefits Form and fax it to our Preverification department at (949) 900-5501 with a copy of your patient's insurance card, if available. You can also fill out our online automated preverification form found here.

Our Preverification team will typically be able to send you an estimate in approximately 72 hours.

If you have any questions, please call us at (949) 900-5794.

To obtain a Preverification of Benefits Form (part of the Test Requisition Form or TRF), please click here. When completing the TRF, please ensure to check the “Insurance Preverification first” box.

Our team will then assign an Ambry Insurance Verification Representative to your case(s), who will contact the insurance company. The insurance company might require an authorization, which may require additional proof of medical necessity. Your Ambry Insurance Verification Representative will contact you to compile the required documents for submission to the insurance company. In most cases, Ambry Insurance Verification Department will be able to submit the authorization on your behalf.  In some cases, submission for authorization will need to come directly from the ordering physician or genetic counselor (dependent on insurance company policies) and we will provide as much information as we can to help you through the process. Our responsibility to you is to provide this information as quickly as we receive it from the insurance company.   

Please note that expected turnaround time for test results begins after testing has been approved by the insurance company and/or patient.

Contracted Health Plans

We are contracted with a long list of U.S. insurance carriers and health plans, either directly or via network providers. Please call us at (949) 900-5794 to verify coverage under specific insurance carriers or health plans.

Hardship Payment Plan

In the event that a patient can demonstrate a personal financial hardship, we can discuss arrangements for a payment plan. We do not charge interest or fees when a payment plan is instituted. Please Contact Us to speak with our Insurance Verification Department if such a situation exists for further information.