We know how difficult it can be to understand your health insurance benefits. As experts in genetic medicine, we are highly skilled in achieving the best outcomes for claims filed with insurance providers for genetic services.


The Billing Process

Patients often have a lot of questions about billing and insurance prior to their appointment. To help you out, we have detailed every step in the patient journey where insurance and/or billing might come up so you can feel completely informed before coming in for your appointment.


 
PRE-APPOINTMENT
  • When scheduling an appointment, Insight will request your insurance information

    • You are encouraged to reach out to your insurance provider prior to your appointment to familiarize yourself with your personal insurance benefits

  • Insight has a list of CPT and ICD codes for you to review with your insurance provider

  • You may also ask to speak with one of our Patient Service team member prior to your appointment to address any questions about billing

APPOINTMENT
  • Your co-pay will be requested at check-in

  • Upon request, you can meet with a Patient Service team member prior to your counseling session

POST-APPOINTMENT
  • One of our billing representatives will contact your insurance provider regarding reimbursement for your services

CLAIM APPROVAL & BILLING
  • You will receive an Estimate of Benefits (EOB) from your insurance provider once they receive your claim. Remember, an EOB is not a bill. Please reach out to ourPatient Services team with any questions

  • Claim processing can take a long time. Your insurance claim might have to go through an appeal process

  • Once your insurance provider finalizes your claim, you may receive a final bill from Insight. An Insight Patient Services team member will contact you regarding any outstanding balance

  • If you are not insured or under-insured, you can receive financial assistance through our Patient Access Care Program. Please ask to speak with our Patient Services Team for more information

 

Still have questions? See answers to frequently asked questions about billing and insurance >

Billing Terms to Know:

  • Co-pay: A fixed amount you must pay for every service date when visiting a healthcare provider.

  • Deductible: A specified amount of money that you must pay out-of-pocket for most allowed medical services before your insurance company will pay any expenses.

  • Co-insurance: A cost-sharing agreement between you and your insurance company. This is the percentage of costs for healthcare services that you are required to pay under your insurance plan, after you meet your deductible, until you meet your out-of-pocket maximum.

  • Prior Authorization: A process used by health insurance companies to determine is they will approve a services or procedure. Prior authorization is not a promise that your plan will cover the cost of the service.

  • CPT Code: Current Procedural Terminology code. A medical code set that is used by healthcare providers to help determine the amount of reimbursement they will receive from an insurance provider for services rendered.

  • Explanation of Benefits (EOB): A written explanation by . your insurance company detailing services that you have been charged for and what the insurance company has agreed to pay. Please note, an EOB is not a bill and you will never pay the amount listed on this document as your final bill from Insight Medical Genetics.