How Billing Works
The billing process is completely unique for each patient, and depends highly on the individual’s insurance plan, level of coverage, and services being performed. Below, we have addressed many of the questions and concerns patients have about billing during their journey with Insight.
Scheduling the appointment
Patients often have questions about insurance while scheduling their first appointment. At this time, we can connect the patient to our financial counselor who can provide answers to initial questions.
Arriving at the appointment
After checking in, patients will be instructed to watch a video related to the counseling, testing and billing process. This video is designed to help patients feel more informed before walking into their appointment.
Patients will also have the opportunity to meet with our financial counselor before their counseling appointment to ask any additional billing or insurance-related questions they might have.
While we cannot fully predict what services a patient’s insurance will cover, we can share with them what the maximum out-of-pocket cost would be if their insurance claim is denied.
A member of our patient advocate team will contact the patient’s insurance company directly to get their claim approved.
The length of time it takes to get a claim processed can range from 3 weeks to 6 months depending on whether the claim has to go through an appeal process.
Sometimes claims are denied partially or fully. In these cases, Insight will continue to appeal to get the entire claim processed.
In the event that your services are not covered or you have high out-of-pocket costs due to your high deductible and/or co-insurance, a member of our patient services team will contact you to discuss your options and next steps as discussed with your genetic counselor.
If a patient is not insured or if they are under-insured, they can receive financial assistance through our Patient Access Care Program.
During the reimbursement process, patients will be mailed an Explanation of Benefits (EOB) by their insurance provider. An EOB is NOT a bill. It is simply a statement of how much was submitted to insurance and the patient’s estimated total liability to their insurance provider. It should be noted that the patient will NEVER pay the amount listed on this statement.
Deductibles, co-pays and co-insurance are all based on the patient’s insurance provider and plan.