Patient Billing

Excellent Coverage, Personalized Support

At Ambry, we believe that each person should be treated as an individual when it comes to genetic testing. This remains true as it pertains to the cost associated with testing. Our goal is to provide you with our high quality genetic testing without cost being a barrier or burden.

Ambry’s Every Patient Individually Considered (E.P.I.C.) philosophy aims to make genetic testing affordable for all patients by addressing the amount each patient will be required to pay as determined by the testing ordered and their insurance coverage. 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 do the rest. 

Insurance:

Many insurance plans cover genetic testing and Ambry is contracted with the majority of U.S. health plans.  Your Out Of Pocket cost may vary based on your individual plan.  We offer personalized verification of insurance coverage and will consider your personal financial situation upon request. 

Self-Pay:

We offer competitive cash pricing when insurance is not an option.

A team of dedicated specialists is available to answer any questions you may have.  Call or email our Billing Department at +1-949-900-5795 or billing@ambrygen.com with any questions.

At Ambry, we understand that there is no ‘one-size-fits-all’ in healthcare; that’s why we will consider your personal financial situation to help make our high-quality genetic testing affordable to you.

Frequently Asked Questions:

Will my test be covered?

  • Coverage will depend upon various factors, such as your health plan’s testing criteria and benefit design, and the medical necessity of the test being ordered.  Ambry has a dedicated team that will discuss these issues with you.

How much will this cost me?

  • Each individual’s costs may be different depending upon a variety of factors.  We are committed to helping you receive the testing you need, by considering all relevant factors that may qualify you for financial assistance.

When can I expect a bill?

  • If you are responsible for any costs, the billing process may take up to 90 days, but in rare instances may take longer.

What is Ambry’s billing policy?

  • For the most up-to-date information regarding our billing policy, all questions should be directed to our Billing Department at +1949.900.5795.

Is financial assistance right for me?

  • Through E.P.I.C., we will proactively consider your personal situation if your financial information is provided on the TRF or supplemental forms, and present you with a cost estimate. Please do not hesitate to contact us directly for more information about our E.P.I.C. program by emailing us at billing@ambrygen.com.

What happens if my test is not covered?

  • We can pre-verify your insurance benefits and may offer the Self-Pay option before the test is run.

If I cannot afford the test, do I have the option to cancel the test?

  • We offer test cancellations within 7 days of the sample receipt date. However, if you are eligible for financial assistance, we are confident that cost will not be a barrier.

What happens if I do not agree with the Out Of Pocket amount?

  • If you ever have any problems with your patient statement, please contact our Billing Department and we will discuss your situation to ensure information accuracy and update as needed.

How is my Out Of Pocket (OOP) amount determined?

  • If you are submitting to your insurance, we offer personalized verification of insurance coverage and will always consider your personal situation for final costs. Typically your OOP is the deductible, co-pay or co-insurance amounts as indicated by your health plan. Many insurance plans cover genetic testing.
  • Ambry will provide you with an estimate of the patient responsibility based on the test ordered, estimated reimbursement and the specific insurer’s contracted rates, in addition to your personal insurance and financial situation.  
  • Your final OOP may be adjusted if, when filling out the TRF with your doctor or genetic counselor, you elected to be considered for our E.P.I.C. program and meet E.P.I.C.’s eligibility requirements.  Your OOP may also be adjusted by your insurance company during the evaluation and processing of your claim.