IGx expects that all patients will be held financially responsible for the full amounts owed. An insured patient’s cost-sharing obligations (such as co-insurance, co-payments, and deductibles) are based on the “allowed amount,” as determined by their insurance plan. An uninsured or self-pay patient’s financial obligation consists of the cost of services provided to them, as published on IGx’s website. IGx will bill patients for the amounts they owe as soon as they are ascertained, and patients must make payment in full within ninety (90) days of the date of the invoice unless alternative payment arrangements are made. Financial assistance is available for eligible patients, in accordance with the policies outlined below.
Before testing, IGx collects the patient’s insurance information along with a copy of the front and back of their insurance cards. IGx will first bill the patient’s insurance plan for services provided to them. Patients covered by commercial insurance will receive an explanation of benefits (EOB), which sets forth the allowed amount and their cost-sharing obligations. IGx will separately bill patients for their cost-sharing obligations, and payment is due within ninety (90) days of the date of the invoice. If a patient receives payment directly from his insurance plan for the portion of testing covered by insurance, the patient is responsible for endorsing and sending the check to IGx within the applicable payment timeframe.
Patients who have questions about their coverage for genetic testing should contact their insurance providers.
Uninsured patients include those who are not covered by any public or private health benefits plan, as well as those who are covered by such a plan but for whom a claim is submitted and denied in its entirety. Patients who are responsible for the entire amount simply because they have a high-deductible health benefits plan are not uninsured under this policy. IGx will bill uninsured patients the same as self-pay patients, and payment is due within ninety (90) days of the date of the invoice.
Patients will receive an early payment discount of 20% if payment is made in full within thirty (30) days of the applicable invoice date. This cannot be combined with the Financial Assistance Program (discussed below).
In cases where IGx cannot collect a lump sum payment for a patient’s financial obligations, reasonable payment plans may be offered. The payment plans will require monthly, interest-free payments.
If a patient disputes the amount of their financial obligations or otherwise does not satisfy their financial obligations within the applicable timeframe, after reasonable efforts to collect, IGx may make a reasonable business decision to offer a commercially reasonable discounted amount (up to a 70% discount of billed charges) to settle the debt. Whether a settlement amount is commercially reasonable will vary from patient to patient, based on the testing performed, the financial obligations at issue, and other circumstances, but IGx will seek to collect as much of the financial obligations as possible, as determined by IGx’s Compliance Billing Director.
If payment has not been made in full, and no alternative payment arrangement or settlement has been agreed to by the applicable due date, a final invoice will be sent to the patient using the contact information on file to advise the patient of the past-due status of his account. Accounts that remain past due after six (6) months will be reviewed by IGx to determine if the amounts owed should be waived, written off as uncollectible, or sent for collection. In the exercise of reasonable business judgment, IGx may elect not to pursue full legal remedies to collect any such outstanding amounts if:
IGx will maintain documentation of all notices, negotiations, settlement offers, and other communications with patients in connection with efforts to collect their financial obligations.
A patient’s financial obligations may only be waived, in whole or in part, upon request by the patient (or responsible legal party) and only after a final determination of the financial obligations owed and verification of income. If applicable, consent must also be obtained from the patient’s insurers to receive financial assistance for their financial obligations. If a waiver of financial obligations is granted, all future financial obligations of the applicable patient may be waived as well, as long as IGx periodically (but not less frequently than annually) re-verifies the patient’s eligibility for financial assistance in accordance with this policy. All information relating to financial assistance requests—including, without limitation, supporting documentation, grants, and denials—will be kept confidential by IGx.
IMPORTANT: Referring providers may be informed of this financial assistance policy, but neither IGx nor any referring provider may publicly advertise the existence of this policy. Communication about the financial assistance policy may involve the use of a pamphlet or flyer, but the information included in such communication must be limited and, in any event, direct the patient to contact IGx for specific details of the policy. IGx and referring providers may disclose the policy if a patient requests a cost estimate or expresses concern about the cost of testing or after receipt of the testing services.
To be eligible for financial assistance, a patient must furnish documentation demonstrating that (1) the patient is at or below 300% of the current federal poverty guidelines (2022 guidelines attached as Exhibit A), or (2) the patient would be unable to pay his or her financial obligations and still be able to pay for other basic, necessary expenses. All eligibility determinations are made on an equal basis.
All patients requesting financial assistance must complete a Financial Disclosure form (attached as Exhibit B). Documentation supporting a patient’s eligibility for financial assistance may consist of one or more of the following:
Patients are encouraged to contact the IGx Billing Department with any questions or concerns about financial assistance. The Billing Customer Care team can be reached at: (210) 352-5175 Ext. 5 Monday through Friday, from 10:00 AM EST – 6:00 PM EST.
Periodically, the Compliance Billing Director (or its designee) will select a representative sample of patients with outstanding financial obligations and collect all pertinent information in connection with such patient’s accounts, including: (i) the patient’s insurance coverage; and (ii) attempts made by IGx to collect such financial obligations. The Compliance Billing Director (or its designee) will prepare and submit its findings to the Chief Financial Officer, together with a recommendation for corrective action as needed.
