A Note On Insurance, Costs, and Payment:
Insight Medical Genetics is made up of two entities functioning seamlessly together – Insight Medical Genetics, LLC, which is primarily our laboratory services, and IMG MD, LLC, which is our clinical and physician services. Though the services you experience are completely integrated, billing your insurance company for these services occurs through both of our entities and, as a result, may seem somewhat confusing.
All of the major health plans recognize Insight Medical Genetics as a participating provider. The meaning of being ‘in-network,’ however, is getting increasingly complicated and we may not be an ‘in-network’ provider for your specific health plan. Additionally, the field of human genetics is very dynamic and rapidly changing which results in better and better patient care but also creates uncertainty with insurance carriers as to levels of coverage. We understand the overall changing landscape of insurance, as well as the nuances related to genetics, and are very willing to discuss your insurance coverage with you over the telephone or when you’re in our office for your appointment; please call 312-477-2977 with your questions.
If You Have Questions About the Explanations of Benefits You Received from Your Health Plan
Once you and your genetic counselor or physician have determined the tests and procedures that are appropriate for you and they have been ordered, we will then bill your insurance carrier. Your health plan may then send you an Explanation of Benefits (EOB). The first thing to keep in mind is that an EOB is not a bill. It is simply a summary of the claim for payment we have made to your insurance company along with their determination of what it thinks your responsibility for payment should be. The reality is that this can actually change over a period of weeks and even months as we may appeal for payment from the insurer when we believe that a claim has not been fairly reimbursed. And again, if there is something you find in the EOB that you have a question about, please call us at 312-477-2977.
If You Have Concerns About the Costs of Genetic Testing… we understand and appreciate that the costs of providing high quality, specialized genetic testing can be substantial. We believe in providing these services in such a way that costs to you will be minimized. We will work diligently to collect from your insurance company to the extent possible and will follow up and file appeals where necessary. In the event we are not able to adequately collect from your insurance company, the patient’s responsibility is set at what we believe to be at a very affordable level. If you have questions or concerns, please ask us about what your out-of-pocket expenses may end up being and if you do receive an invoice from us, do not hesitate to call at 312-477-2977 with any questions.
If You Have Further Questions Regarding Your Insurance or a bill you received… please do not hesitate to call us. If someone from our billing department is not immediately available, you will receive a return phone call by the end of the next business day.