Billing & Insurance
Pre-payment is required for all test orders, except Medicare patients. Payment is processed once we receive an order and determine that all samples are suitable for testing. We will contact the patient via phone and/or e-mail if payment information is not included with the paperwork or if there is an issue when processing payment. If samples arrive without payment information, we can only guarantee testing five business days after arrival. Testing will commence once payment is processed. The turn-around-time for testing is two to three weeks after receipt of payment.
Private Insurance (BC/BS, Aetna, Cigna, etc.)
We see reimbursements for all tests across insurance providers and plans. We are happy to file a claim for medical reimbursement to the insurance provider on behalf of the patient once testing is complete. Please provide complete insurance information on the billing form, as well as a photocopy of the front and back of the insurance card and driver’s license, and make sure ICD-10 diagnosis codes are listed on the test request form.
Please note that our lab is not contracted with any private insurance providers at this time, so claims will be submitted on an out-of-network (OON) basis. Please be patient as the claims process can take a few weeks before your insurance provider responds to the claim.
Original Medicare/Medicare Advantage
Galaxy Diagnostics is an Original Medicare provider. Medicare patients are not required to pre-pay for testing. However, Medicare patients are still responsible for the cost of testing in the event that Medicare denies the claim. For claims processing, photocopies of the front and back of your Medicare card and driver’s license must be submitted with the completed ABN form. Following federal regulations, the Medicare Advance Beneficiary Notice (ABN) must be signed and submitted with the sample indicating that the patient is aware that Medicare may decline to cover this testing. We regularly see Medicare reimbursements, but there are other factors that determine Medicare coverage and may lead to a rejected claim.
*Please note that Medicare Advantage (MA) plans are different than Original Medicare. MA plans are administered through private insurers (Aetna, Blue Cross/Blue Shield, etc.) with which Galaxy is not currently in-network. This may affect coverage determinations. We encourage you to read more about it here and call your insurance provider for more information including a predetermination of coverage.
If you have any questions concerning the billing process, please contact our business office at contact@galaxydx.com or 919-313-9672.
