Ambry Genetics reports results from clinical diagnostic exome™ testing of three patients.
Insurance Billing & Insurance Preverification Request
Ambry Genetics requires that all insurance cases come with
a fully completed Test Requisition Form, including ICD-9 codes. HMO authorizations or referrals should be attached.
Please send a copy of the front and back of the patient’s insurance card for both primary and secondary insurance carriers. If the card is not available, a copy of the patient's demographic information or their clinic registration and billing form should be submitted.
Status of benefits will be verified by Ambry Genetics 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
We understand the medical insurance process can be challenging. The first step is to complete an Insurance Preverification Request Form and fax it to the Billing Department at (949) 900-5501 with a copy of the patient's insurance card, if available.
General
Exome Test Requistion, Preverification, & Consent Form - Proband
Exome Test Requistion Form (Without Consent Form) - Proband
Our team will then assign a specialist to your case(s) who will contact the insurance company. The insurer might require additional proof of medical necessity, at which time your specialist will contact you to compile the required documents for our submission. In most cases, we will get verification from the insurer within 24 hours. Our responsibility to you is to provide this information as quickly as we receive it from the insurer.
General
Exome Test Requistion, Preverification, & Consent Form - Proband
Exome Test Requistion Form (Without Consent Form) - Proband
Our team will then assign a specialist to your case(s) who will contact the insurance company. The insurer might require additional proof of medical necessity, at which time your specialist will contact you to compile the required documents for our submission. In most cases, we will get verification from the insurer within 24 hours. Our responsibility to you is to provide this information as quickly as we receive it from the insurer.
Insurance billing can be complicated, and we're here to help. Please call us at (949) 900-5500 ext# 362 or email us at preverification@ambrygen.com if you need our assistance.
Contracted Health Plans
Ambry Genetics is contracted with a long list of insurance carriers and health plans, either directly or via network providers. Please call Ambry Genetics at (949) 900-5500 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 Billing Department if such a situation exists for further information.
Please see our printable Insurance Preverification Form for full details regarding the process of Insurance Preverification.