Insurance: Billing

Verification of insurance benefits is the responsibility of the referring provider. The referring physician should establish the requirements for preauthorization. For ALL insurance billing options, the indication(s) for testing and/or appropriate ICD-9 codes ARE REQUIRED for billing and result interpretation purposes.

Emory Genetics Laboratory has a Managed Care Contract List for individuals who reside in GA. Preauthorization is not typically required for contracted PPO and POS policies, however, not all individual policies cover genetics testing.

If preauthorization is not required (includes Georgia Medicaid), Emory Genetics Laboratory will initiate testing of a specimen when the following is received:

• A completed Test Requisition Form with patient signature
• A legible photocopy (front and back) of the patient’s insurance card

If preauthorization is required (includes Wellcare, Peachstate and Amerigroup), Emory Genetics Laboratory will initiate testing of a specimen when the following is received:

• A completed Test Requisition Form with patient signature
• A legible photocopy (front and back) of the patient’s insurance card

AND at least one of the following:


• Proof of preauthorization
• A completed Insurance Verification/Authorization Form with patient signature. Emory Genetics Laboratory will verify insurance benefits and seek preauthorization on the patient’s behalf
• Valid credit card information with signed patient authorization to bill for services not covered by insurance

Upon determination of benefits, a member of the Emory Genetics Laboratory staff will notify the patient of any expected out of pocket expenses and preauthorization status. The patient will be expected to make payment for out of pocket expenses (see Patient Payment options). Testing will not be started before payment is made. Preauthorization for most testing should be completed in 1-2 weeks.

If the patient does not want the testing to be delayed, they may provide credit card information with sample submission. Emory Genetics Laboratory will bill the patient’s insurance for services requested and performed. Emory Genetics Laboratory will bill the patient’s credit card account for any portion of the test that is not covered by their insurance except where the patient’s liability is limited due to contract or State or Federal Law.