The available billing options depend on the type of test you are ordering. Please see below for options and definitions.

Billing Options

Patient Pay
Institutional Billing
Insurance Billing
Diagnostic/Reflex
Supplemental Newborn Screening
*
Carrier Screening
* Insurance billing can be requested, but payment must be received prior to processing sample(s). Reimbursement will be issued if payment is received by insurance.

Patient Pay: Patient is responsible for paying the full amount prior to sample processing. Financing options are available if necessary. Please contact us for more information.

Institutional Billing: Institutional accounts are available for referring clinics, physicians, laboratories, and/or hospitals.  Institutional account clients are invoiced monthly and agree that their institution will pay for all testing ordered by their institution.  Volume-based pricing discounts are available to institutional account clients. A fully executed service agreement must be on file before testing of samples can be initiated.  Tests received from an institutional billing account cannot be revised to insurance billing. To enroll in Baby Genes Institutional billing, download and complete the Institutional Account Request Form.

Insurance Billing:  Insurance coverage on genetic testing varies by plan and insurance company. If Baby Genes is an participating provider for your insurance company, a claim will be submitted by Baby Genes for services provided. If Baby Genes is an out of network provider for your insurance or a preauthorization is denied, a deposit is required to proceed with sample processing. Baby Genes will submit a claim for services and refund the deposit if payment is received from your insurance company. Please see below for more details regarding insurance billing and accepted insurance polices.


Patient Pay Pricing

If you are interested in patient pay, please contact us for pricing.

Patient Ordering

Physician and Institutional Pricing

If you are an ordering physician or institution, please contact us for pricing.


Physician and Institutional Ordering

Insurance Billing

Many insurances require preauthorization prior to genetic testing services, so please contact the insurance carrier prior to testing. If a letter of medical necessity is required, a template can be provided. Please contact your insurance company for coverage and benefits information. If a current procedural terminology (CPT) code is desired, please contact us for specific information.

Upon receipt of a specimen, Baby Genes will evaluate the patient’s insurance and determine if a cash deposit is required prior to sample processing. If Baby Genes is a participating provider with your insurance and pre-authorization is approved, the sample will be immediately processed. Baby Genes will submit a claim to your insurance for services rendered. If Baby Genes is not a participating provider with your insurance and/or pre-authorization is denied, a deposit will be required to commence processing. If the pre-authorization is denied, the patient will be charged the full patient-pay amount for the test and processing will begin after payment is received. If pre-authorization is approved, a deposit will be required to begin processing and a claim will be submitted by Baby Genes. If insurance reimbursement is received, Baby Genes will refund the deposit to the patient.

Baby Genes is a registered provider with the Medicaid plans listed below. Although we are a registered provider, some plans may not cover genetic testing; therefore, please contact Baby Genes or your state Medicaid to determine if the testing is covered under your particular plan.

Medicaid Plans: 

  • Colorado Medicaid
  • Georgia Medicaid
  • Idaho Medicaid
  • Louisiana Medicaid
  • Minnesota Medicaid
  • Montana Medicaid
  • Nebraska Medicaid
  • New Mexico Medicaid
  • North Dakota Medicaid
  • Oklahoma Medicaid
  • South Carolina Medicaid
  • Wyoming Medicaid

Medicare Plans:

Baby Genes is a participating Medicare Part B provider.

Private Insurance:

Baby Genes is not currently contracted with private insurance. Network contracts are pending, and information will be available when accepted. Please contact your insurance provider to determine out-of-network coverage within your plan.