Many insurance companies cover PGx testing, depending on your plan and the reasons your test was ordered. The out-of-pocket cost of PGx testing varies depending on your health insurance coverage.
If AccessDx expects you to be billed for all or a portion of the test, we will contact you by phone before your sample is processed to offer you Express Pay. When contacted, you will have 72 hours to respond to AccessDx and confirm whether you’d like to use Express Pay or have your insurance provider billed.
If you do not respond within 72 hours, AccessDx will process your sample, and once resulted, AccessDx will bill your insurance. Once your sample is resulted, Express Pay will no longer be available.
If you choose Express Pay, the amount paid will not apply toward your annual deductible or out-of-pocket costs for your insurance plan, and no claim can be submitted to your insurance for reimbursement of the Express Pay amount.
If you choose to have your insurance billed, your insurance company may send an Explanation of Benefits (EOB). This is not a bill. If you receive an EOB and have questions, please contact us.
If you meet the criteria for the Centers for Medicare & Medicaid Services (CMS) coverage, there is no out-of-pocket expense. If you do not meet the coverage criteria, AccessDx will contact your healthcare provider.
