Billing and Payment Option

Mira Dx® has three ways to bill for services.  The following information is necessary for the different options.
 
1. Commercial Insurance:
Mira Dx® will verify coverage and determine financial responsibility for each patient. A priority is to make the PreOvar® test available to all appropriate patients.  As part of that commitment, Mira Dx® has a maximum out of pocket expense of $95.  If the patient’s total financial responsibility will exceed $95 for any reason, including co-insurance, deductible, or non-covered services, Mira Dx® will contact the patient directly to discuss the specifics of the case and options available  before proceeding with the testing process.  If the total financial responsibility will NOT exceed $95, the patient will NOT be contacted, and sample processing will begin immediately. Please call Mira Dx® billing at  1-800-640-0683 with any questions.

In order to proceed with the Insurance Billing option, the patient signature on the Test Requisition Form and enlarged photocopies of the front and back of the patient's health insurance card(s) are required.  Mira Dx® will submit bills directly to the insurance carrier and will also appeal and resubmit claims on each patient’s behalf, with input from the authorized healthcare provider as needed.

Mira Dx® is not a participating provider in any Medicaid program or with Medicare.  Medicaid and Medicare patients may qualify for the Financial Assistance Program (FAP).  To request this, a patient must submit a completed Financial Assistance Program Application. Completed applications will be reviewed and testing will be completed if the application is approved. Please contact Mira Dx® Billing at 1-800-640-0683 or download the Financial Assistance Program Application.

2. Self-Pay Patients:
Individuals who desire to pay "out of pocket" for Mira Dx® testing services should ensure that credit card information, money order or a personal check for the cost of the test accompany the order.  Orders without payment information requesting this option may be delayed.
 
3. Direct Client Billing to Hospitals, Laboratories or Clinics: 
Mira Dx® will directly bill a Hospital, Reference Laboratory, and/or a Clinic for all services provided for a patient as requested.  Direct billing helps to avoid delays in processing orders since it simplifies the ordering process.  It is then the responsibility of the Hospital, Laboratory or Clinic to submit a claim to the patient's insurance company for reimbursement.