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GeneDx Healthcare Provider Quick Guide: Performing a

Details: health insurance company. • BIs are not a confirmation that a test has been authorized by your patient’s health insurance company. A Prior Authorization may still be required. • BIs are a snapshot of a patient’s commercial health insurance coverage. Therefore, they may only

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GeneDx Healthcare Provider Guide: Benefit Investigation FAQs

Details: health insurance company directly, to ask about their estimated OOP amount. Patients shall be financially responsible for the OOP amount solely determined by their health insurance company based on the patient’s medical benefit plan. What happens if a provider orders a test but forgets to perform a BI before the sample is sent to GeneDx?

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› Url: https://www.genedx.com/wp-content/uploads/2021/01/GeneDx-Healthcare-Provider-Benefit-Investigation-FAQs-v2-02-2021-FINAL.pdf Go Now

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United Health Care (UHC)

Details: United Health Care (UHC) As of January 1st, 2020 United Healthcare (UHC) implemented changes to its molecular pathology policy. This policy change will have direct impact on panel test orders. Due to this change, we are recommending a new test ordering sequence for patients with UHC health insurance plans to minimize their costs.

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More About Use of Specimens and Genetic Information

Details: De-identified health history and genetic information can help healthcare providers and researchers understand how genes affect health. Though people undergoing testing may not personally or directly benefit, sharing this information may help healthcare providers offer better care for their patients.

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› Url: https://www.genedx.com/all-forms/use-of-specimen-and-genetic-information/ Go Now

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GeneDx Healthcare Provider Portal Quick Guide: How to

Details: • Patient’s health insurance card informationfor insurance -bill orders • Any and all ICD-10 diagnosis code(s) to the highest level of specificity for the patient • Clinical records, previous testing results, genetic counseling summary, family pedigree, etc. Process.

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› Url: https://www.genedx.com/wp-content/uploads/2021/01/GeneDx-Provider-Portal-Quick-Guide-How-to-Create-an-Order-v1-01.2021-FINAL.pdf Go Now

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Pulmonary Arterial Hypertension Panel

Details: 81405x2, 81406x2. New York Approved. Yes. ABN Required. Yes. For price inquiries please email [email protected] **The CPT codes provided are based on AMA guidelines and are for informational purposes only. CPT coding is the sole responsibility of the billing party. Please direct any questions regarding coding to the payer being billed.

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Provider Portal Information

Details: The GeneDx Provider Portal provides a fast, efficient, secure, and HIPAA-compliant way for healthcare providers to order tests and access their patients’ test result reports. Ordering through the portal allows for a more streamlined ordering process with: Instant benefit investigation results. Easy upload of clinical documents with the order.

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› Url: https://www.genedx.com/portalinfo/ Go Now

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Small Fiber Neuropathy (SFN)

Details: Small fiber neuropathy (SFN) results in neuropathic pain that is often described as burning, tingling, or stabbing and typically begins in the distal extremities. Pain is often associated with autonomic symptoms such as orthostatic dizziness, palpitations, dry eyes, and dry mouth. Some individuals report that episodes are triggered by heat or

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Hereditary Prostate Cancer Panel

Details: In all other situations, complete the New York Exemption Form and fax it to the NYS Department of Health to obtain case-by-case permission before shipping the specimen to GeneDx. NYS Dept. of Health …

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Telehealth Support for Genetic Testing

Details: Our clinical team is available via email and over the phone and to support providers through the entire ordering process, including providing you with verbal results, if needed. MyGeneTeam, LLC, a GeneDx preferred partner, is available to provide genetic counseling services …

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› Url: https://www.genedx.com/telehealth/ Go Now

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Previously Tested at Research Facility

Details: Guidelines: Must be ordered by a physician, genetic counselor or other health care professional. A new sample (usually blood or buccal swab) from the individual is required to confirm that the variant is present.; This confirmation of the variant in the previously-tested individual is necessary before we can perform carrier testing or prenatal diagnosis in the family.

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OPKO Health’s BioReference Laboratories and GeneDx

Details: Health, the New York City Health and Hospital Corporation (NYC Health + Hospitals), the State of New Jersey, the State of Florida and the cities of Detroit and Miami to provide COVID-19 testing. BioReference is offering a real-time reverse-transcription polymerase chain reaction (real-time

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› Url: https://www.genedx.com/wp-content/uploads/2020/04/GeneDx-COVID-19-Testing-Media-Release-4.21.20.pdf Go Now

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Pseudoxanthoma Elasticum (PXE)

Details: Molecular confirmation of a clinical diagnosis. To assist with decisions about treatment and management. Testing of at-risk relatives for specific known variant (s) previously identified in an affected family member. Prenatal diagnosis for known familial pathogenic variant (s) in at-risk pregnancies.

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Insurance Billing

Details: Insurance Billing Institutional Billing Self-Pay Pay My Bill Financial Assistance Program Insurance Forms. Using Commercial Insurance with GeneDx. Information provided on this page is intended only for U.S.-based patients. GeneDx accepts all commercial insurance and we are in-network with the majority of commercial health plans.

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Letters of Medical Necessity

Details: Cardiology Letters of Medical Necessity. Arrhythmia Panel. Arrhythmogenic Right Ventricular Cardiomyopathy (ARVC) Brugada Syndrome (BrS) Cardiomyopathy Panel. Catecholaminergic Polymorphic Ventricular Tachycardia (CPVT) Combined Cardiac Panel. Cutis Laxa Panel. Dilated Cardiomyopathy (DCM)

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Lynch/Colorectal High Risk Panel

Details: Colorectal or endometrial cancer diagnosed under 50 years of age; Multiple colon polyps (especially ≥ 20 adenomas) at any age; Tumor testing which indicates an increased risk for a hereditary cancer syndrome known as Lynch syndrome (e.g. microsatellite instability and/or lack of immunohistochemistry staining for a mismatch repair protein)

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AUTHORIZATION FOR RELEASE OF PATIENT GENETIC …

Details: Self Health Care Provider Researcher† Other (specify): PLEASE RELEASE GENETIC DATA TO: The format of the data file released will be dependent on the type of test performed. Exome and genome data will be provided as CRAM and VCF files.

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› Url: https://www.genedx.com/wp-content/uploads/2019/09/GeneDx-Authorization-For-Release-of-Patient-Data-2019-FINAL.pdf Go Now

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FINANCIAL ASSISTANCE APPLICATION

Details: Governmental health plans and some commercial health plans will not allow GeneDx to offer financial assistance. Financial assistance is not available for self-pay. If you are covered by any governmental health insurance such as Medicare, Medicaid, Managed Medicaid, Medicare Advantage, Tricare,

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Genetic Testing for Hereditary Neuropathy

Details: health history, family health history, complete neurological exam and neurological tests. • Clinical and Family History: • The medical and family history may indicate whether the neuropathy is likely due to an acquired or genetic cause • The mode of inheritance can be helpful in differentiating possible diagnoses

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Requisition Forms and Additional Information

Details: GeneDx is a world leader in genomics with an acknowledged expertise in rare and ultra-rare genetic disorders, as well as an unparalleled comprehensive genetic testing menu.

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Hereditary Hemorrhagic Telangiectasia (HHT)

Details: Hereditary hemorrhagic telangiectasia (HHT) affects 1 in 5,000 –10,000 individuals. It is a vascular disorder characterized by telangiectasias, arteriovenous malformations (AVMs), and recurrent nose bleeds (epistaxis). Telangiectasias are commonly detected on the buccal mucosa, tongue, lips, face, fingers, and chest, while AVMs are often

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REFERENCE GUIDE: BRCA1/2 GENETIC TESTING: MEDICARE …

Details: • Individuals with little known family health history • Individuals who come from small families • In the case of sex-specific conditions, individuals who have few female/male relatives at risk of developing a particular condition It is important to note that Medicare DOES NOT cover BRCA1/2 testing without a personal history of cancer

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Financial Assistance Program

Details: Certain commercial health insurance plans ; Any federally or state-funded insurance plans (e.g. Medicare, Medicaid, Tricare) Patients utilizing self-pay; How to apply: Download the Financial Assistance Application. English Form Spanish Form. Complete the application. Gather required financial documents.

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