Billing and Reimbursement
Mira Dx has three ways to bill for the services performed in our CLIA laboratory. In order to help manage this process, we need different types of information from our customers.
1. 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.
2. Commercial Insurance:
Mira Dx will directly bill an insurance company for those commercially insured patients with plans covering diagnostic testing, including genetic testing when a test is ordered.
3. Self-Pay Patients:
Individuals interested in paying "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 may be delayed.
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 customer service at (203) 789-9000 or download the Financial Assistance Program Application.
FREQUENTLY ASKED QUESTIONS
What is the price of the PreOvar Test?
The PreOvar test is priced at $1295. Mira Dx does offer discounted pricing for Self-Pay and individuals that qualify for the Financial Assistance Program. For more information on pricing call Mira Dx at 203-789-9000.
What is my maximum out of pocket expense for the PreOvar test?
Mira Dx works to make this test available to all patients who need it. As part of that commitment Mira Dx has a maximum out of pocket expense. Please call for details.
Does the commercial insurance program include Medicare and Medicaid?
Commercial insurance does not include Federal health care programs such as Medicare, Medicare HMO, Medicare PPO, Medicaid, and Tricare/Champus, programs for which there is a specific government-mandated billing process. Patients should verify coverage with their individual provider prior to testing.
Patients with a commercial insurance plan for which Mira Dx is a contracted provider:
Patients with a commercial insurance plan for which Mira Dx is a contracted provider are subject to the deductible and co-insurance obligations of their plan. For these patients, Mira Dx will bill insurance directly for all of our services and there will be no up-front charges paid to Mira Dx by the patient. Mira Dx will forward the appropriate notification of obligation to the patient as specified by the Explanation of Benefits (EOB). In all instances, Mira Dx will adhere to the terms of the patient’s individual policy insofar as payments for services are concerned. Patients should check with their local provider for pre-authorization and coverage questions related to our services.
Patients with a commercial insurance plan for which Mira Dx is not a contracted provider:
Because insurance companies do not always cover the full cost of diagnostic testing, Mira Dx has established the maximum out of pocket expense for patients covered by commercial insurance for which Mira Dx is not a contracted provider. Ordinarily, any charge not covered by an insurance plan for which Mira Dx is not a contracted provider would be billed by Mira Dx directly to the patient, and any disputes about the amount covered would be appealed directly to the insurance company by the patient. Please be aware that non-contracted payers may send correspondence including payment to the patient directly. Mira Dx will work with the patient to retrieve the payment and/or correspondence for the PreOvar test.