Billing Policy

Applied InGENuity Diagnostics Billing Policy – Simple Pay

Our patient advocates are available to assist you are experts in our billing process  navigating the claims process. They can be reached at 877-277-5439  on Monday – Friday from 8:00 AM – 5:00 PM EST, with any questions regarding the following billing options and/or status of your account with Applied Ingenuity Diagnostics (aiDX).

Insurance Billing:

Medicare

Applied InGENuity Diagnostics is a Medicare provider and therefore is able to accept Medicare patient samples if covered by Medicare coverage policy. A completed Advance Beneficiary Notice (ABN) is required when Medicare medical necessity criteria are not met.

Commercial Insurance Patients

Applied InGENuity Diagnostics will bill the patient’s insurance provider as an out-of network laboratory. Also, the patient is responsible for the co-pay, co-insurance and unmet deductible established by his or her insurance carrier. In addition, we will perform a requested benefits investigation (BI) to estimate the patient’s out-of-pocket cost. Finally, we will attempt to contact the patient if the patient’s estimated out-of-pocket cost is expected to be greater than $100.

We offer two payment options for patient responsibilities:

Option 1: Pre-Payment Discount

• As a patient you have the option, at the time of draw with a phlebotomist, to pay for the patient portion of your lab work by Simple Pay enrollment. Additionally, Simple Pay makes the patient portion of the lab bill clear and straightforward.

Moreover, with Simple Pay, Applied InGENuity Diagnostics agrees to accept payment from the patient for 40% of what his/her insurance company will bill with a minimum value of $50, and not to exceed $195, for the patient’s portion of the bill. In this situation, the patient may enroll by providing any of the following:

• a valid e-mail address
• mobile telephone number
• a copy of your insurance card
• or a payment authorization form.

Option 2: Prompt-Payment Discount

• Later, once all testing is complete, an invoice for the patient’s portion of the bill, will be sent to patients who did not fill, sign, and date a payment authorization form. Also, Applied InGENuity Diagnostics will only invoice the patient for all completed testing at a rate plus a minimum charge of $100, but will not exceed $225. In addition, 15 days will be allotted to contact the billing department and submit payment.
• Also, if Applied InGENuity Diagnostics has not received payment within 30 days of specimen receipt, any remaining balance not paid by insurance will be billed to the patient and Simple Pay will no longer be an option.

Please note:

If your insurance company sends a check directly to you as payment for our services, you must (i) sign and write “Pay to the Order of “Applied Ingenuity Diagnostics ” on the back of the check and send the check to us or (ii) make a payment to “Applied Ingenuity Diagnostics” for the amount you received from the insurance company and include a copy of the Explanation of Benefits that you received. If we have not received a signed check or payment from the patient, within 15 business days, Applied InGENuity Diagnostics will invoice the patient. All checks should be sent to:

Applied Ingenuity Diagnostics

Attention: Billing Department

2603 NW 13TH ST STE 342

GAINESVILLE FL 32609-2835

Other Methods of Payment Accepted

• Major credit card – Visa, MasterCard and AMEX
• Check, e-Check or money order

A few important notes:

• Your insurance company may take 30-90 days to review and pay a claim.
• Once a claim is reviewed, your insurer typically sends you an explanation of benefits (EOB). This is not a bill – rather it explains what they will pay for these services and why.
• It is important to note that your insurer determines the extent to which  lab tests are covered and defined in your policy. It is your responsibility to know the reimbursement policy your insurer provides for laboratory tests. Unfortunately, Applied InGENuity Diagnostics may not participate in the pricing policies of your insurance.
• For traditional Medicare patients (All Non-Managed Medicare), there is no out of pocket costs for laboratory tests when the testing ordered meets Medicare’s Medical Necessity guidelines.
• In most instances, patients who have a Health Maintenance Organization (HMO) product are required to use a designated laboratory to obtain laboratory services. If you elect to utilize aiDX for laboratory testing when enrolled in an HMO product, the claim will likely be denied by your insurance company and you will be financially responsible for any services.
• For patients that have either a Health Reimbursement Account (HRA) or a Health Savings Account (HSA), your insurance company may automatically debit the funds allocated in your Health Reimbursement Account (HRA)/ Health Savings Account (HSA) and remit payment to aiDX without requiring the consent of the patient. In this case, aiDX will refund the patient any excess amounts collected.