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Billing and Payment Options

Hereditary Cancer Tests (BRACAnalysis®, COLARIS®, COLARIS AP®, MELARIS® and PANEXIA)
TheraGuide®

Hereditary Cancer Tests (BRACAnalysis, COLARIS, COLARIS AP, MELARIS and PANEXIA):

Most insurance carriers cover genetic testing services for hereditary cancer. In fact, although each situation is unique, the average patient pays a coinsurance of less than $100. Myriad assists in obtaining the best possible reimbursement for each of the genetic tests we offer. Our goal is to ensure that your patients receive the appropriate coverage from their plan.
There are several payment options available:
 

Option 1- Insurance Billing:

If the Insurance Billing option is selected on the Test Request Form, Myriad will verify coverage and determine the patient’s financial responsibility. If the patient's total financial responsibility will exceed $375 (or $15 per month when utilizing our interest-free 25-month payment plan) for any reason, including co-insurance, deductible, or non-covered services, we will contact the patient directly to discuss the specifics of the case and options available to the patient before proceeding with the testing process. If their total financial responsibility will NOT exceed $375, your patient will NOT be contacted, and sample processing will begin immediately.

Note:  Some insurers may require a pre-authorization before the sample is initiated, which may delay the start of the test. We will notify your office if this is the case.

In order to proceed with the Insurance Billing option, the Patient/Responsible Party signature on the Test Request Form and enlarged photocopies of the front and back of the patient's health insurance card(s) are required. Myriad will submit bills directly to the patient's insurance carrier and will also appeal and resubmit claims on the patient’s behalf, with input from you as the authorized healthcare provider as needed. 

Myriad Financial Assistance Program (MFAP)

Myriad offers testing at no charge to uninsured patients that meet specific financial and medical criteria. Due to regulatory limitations, patients who are recipients of government funded programs (i.e. Medicaid, Medicare) or those that have any third-party insurance are not eligible to apply for MFAP.  Qualification requirements and the submission instructions are provided below:
 

To view the current HHS financial guidelines, please view the link below.  http://aspe.hhs.gov/poverty/index.shtml

Option 2 – Patient Payment:

The patient has an option to self-pay for testing. Patients may provide credit card information on the Test Request Form, provide a check or money order payable to Myriad Genetic Laboratories, Inc. for testing services. Myriad also offers interest free payment plans. Please have the patient call Myriad Customer Service at 800-469-7423 for payment information.

Option 3 – Other Billing (Bill Institution/Research/MGA):

Bill Institution:

The Bill Institution option should be selected if the facility would like to be billed for the test charges. Please provide your Bill Institution account number on the test request form. If you do not have a Bill Institution account number, please submit billing information with specimen including: name of institution, responsible party name, billing address, phone and fax.

Research:

The research project code should be specified on the Test Request Form only if the facility has a current research project with Myriad Genetic Laboratories.

Myriad Genetics Authorization (MGA):

The MGA option should be marked if Myriad has authorized research testing for this particular patient. Please make sure that MGA number is provided on the test request form, and the relationship to the known mutation carrier is specified.

Should the patient have any questions regarding billing questions after the test is complete, the patient is encouraged to contact our Billing Department at 800-725-2722.

 

TheraGuide®

Option 1 - Insurance Billing:

Myriad will bill the insurance carrier for TheraGuide. Testing will begin upon receipt of the sample. A completed Test Request Form (with patient signature), and enlarged photocopy of the front and back of patients' insurance card is required. Myriad will submit bills directly to insurance carriers and will appeal and resubmit claims if necessary.

Medicare

Medicare has not established a coverage policy for TheraGuide testing.  For Medicare patients, an Advance Beneficiary Notice of Non-coverage (ABN) is required before testing can begin. Because Medicare will not cover test costs until a reimbursement policy has been established, test costs will be billed directly to the patient. A summary of instructions and documentation requirements for Medicare patients is included on page 1 of the ABN.

You can download the ABN (including Medicare information) form by clicking on one of the links below.
Myriad-ABN.pdf
Patient Protection Program:

For a limited time, Myriad will be offering the TheraGuide Patient Protection Program. This program is designed to protect patients undergoing chemotherapy from unexpected financial burden due to limited insurance coverage during the introduction of TheraGuide testing.

Qualifying patients* for whom TheraGuide has been performed may be eligible for the program.  You will continue to be responsible for any applicable deductible and copayment amounts according to your health plan.  However, your out-of-pocket costs will be limited to the greater of your applicable deductible and/or copayment OR 20% of Myriad's billed charges.

To participate, qualifying patients* who opted for Insurance Billing as described above may, after receiving a billing invoice from Myriad, contact Myriad's Billing Department at the toll-free number that appears on the invoice (800-725-2722) to complete a program application.  In the case of an insurance denial, you must agree to cooperate with Myriad's appeal to the insurance company for coverage.

*A qualifying patient is one that is being considered for, or is currently receiving, 5-FU therapy as a result of a cancer diagnosis, is a member of a private health insurance program, and resides in a jurisdiction where such a program is not prohibited by law. Patients covered under Medicare, Medicaid, or other government program or reside in Florida, Massachusetts, Texas, Minnesota, Rhode Island, or other states where such a program is prohibited are not eligible for the Patient Protection Program.

Myriad Financial Assistance Program (MFAP):

Myriad offers testing at no charge to uninsured patients who meet specific financial and medical criteria.  Due to regulatory limitations, patients who are recipients of government funded programs (i.e., Medicaid, Medicare) or those that have any third-party insurance are not eligible to apply for MFAP.

Qualification requirements and the submission instructions are provided below:
 

To view the current HHS financial guidelines, please view the link below.  http://aspe.hhs.gov/poverty/index.shtml

Option 2 - Patient Payment

The patient has an option to self-pay for testing.  Patients may provide credit card information on the Test Request Form, provide a check or money order payable to Myriad Genetic Laboratories, Inc. for testing services. Myriad also offers interest free payment plans.  Please have the patient call Myriad Customer Service at 800-469-7423 for payment information.

 

 

BRACAnalysis, COLARIS, COLARIS AP, MELARIS, Myriad myPath, myPlan, myRisk, TheraGuide, PREZEON, PANEXIA, and Prolaris are either trademarks or registered trademarks of Myriad Genetics, Inc. in the United States and other jurisdictions