Patient Advocacy Program
Assisting your patients with access to SignatureChip® microarray analysis.
Services Offered
Benefit Investigations
Through our Patient Advocacy Program, the patient's authorized healthcare provider can request a Benefit Investigation prior to or at the time of sample receipt. Once a completed Patient Financial Authorization/Insurance Benefit Investigation Form has been received, the Patient Advocacy Team will work with the patient's insurance carrier to determine the benefits available for clinical laboratory testing. We will communicate the plan benefit information back to the patient and the healthcare provider.
- Physician / Genetic Counselor and patient discuss the need for SignatureChip® testing.
- A Patient Insurance Benefit Verification / Authorization form is completed and faxed to the Patient Advocacy Team.
- The patient's benefit information is obtained. When required, a prior authorization is requested.
- The Patient Advocacy Team contacts the patient and physician with the results of the Benefit Investigation.
Prior Authorizations
Our staff will obtain pre-authorization on the patient's behalf if required.
Claim Processing
After the test results have been released to the physician, the Patient Advocacy Team will submit a claim requesting payment from the patient's insurance carrier.
- The physician completes the requisition form and submits the sample to Signature Genomic Laboratories.
- The test is completed and the results are sent to the physician.
- The patient's demographic and charge information is sent electronically to the Patient Advocacy Team for billing.
- A claim form is created and the patient's insurance is billed.
Appeals
If the patient's insurance carrier refuses to pay for some or all of the cost of the test, the Patient Advocacy Team will work with the patient to submit an appeal. The Patient Advocacy Team will submit up to three appeals, including an external review, to exhaust all options for payment.
- A denial or partial payment is received from the patient's insurance carrier.
- The insurance carrier's appeal process and guidelines are obtained.
- A provider appeal is drafted. When required, the patient is contacted to assist with the appeals process.
- The appeal letter and supporting documentation is sent to the patient's insurance carrier.
Payment Plans
If a balance remains after we have completed the billing and appeals processes, we will work with the patient to determine a payment plan.