MicroGenDX is a laboratory service that provides physicians a diagnostic tool to identify bacteria and fungal microbes, which can be causing an infection. Before making a treatment decision or prescribing an antibiotic your physician needs to know the type of microorganism at the site of infection.
MicroGenDX is a molecular laboratory that uses the latest technology to identify the microbes by their DNA. Just as you have your own unique DNA, every species of bacteria or fungus has its own unique DNA. We now have a database with the DNA of over 25,000 species of microbes! By knowing the DNA of thousands of species of bacteria and fungus, we can extract the DNA from your sample and match it to this database!
Scientists have used DNA to identify microbes for many years and believe the technology is the Gold Standard for identifying microbes. In the past the technology was too expensive and took too long to use in human medicine, until now. MicroGenDX is the world leader in using Next Generation Sequencing to detect and identify microorganisms.
Your doctor could have used another diagnostic tool for identifying bacteria or fungus and that tool is likely a traditional culture. Your insurance carrier may have covered the cost of a traditional culture but you should understand the differences between a culture and DNA sampling.
Culture means to grow. The traditional culture has been the primary diagnostic tool for detecting microbes since its discovery in 1870. Less than 1% of microbes will grow in culture! Your samples also needs to be at the culture lab in 2 hours and kept at room temperature. (If not, it will not grow) When you see the lab boxes sitting outside of your physician office, that is where your sample will often sit for hours before being picked up! (DNA samples are not as sensitive to time and temperature).
This means that DNA technology used by MicroGenDX is more accurate than culture in detecting the bacteria and fungus causing your symptoms. Now your doctor has better information to prescribe the right treatment. It could mean the difference in you feeling better faster. It will also be lower cost to you from not having to pay for repeat office visits and repeated courses of antibiotics can be the result of a culture being wrong.
Our Commitment to Supporting your Office
It’s our priority to make use of our test as easy as possible for your office staff and will show them what the patient needs to sign and why. (If Patients have Aetna or one of the BC plans and/or have no insurance coverage) We are focused on our testing service being covered by more of these BC plans and will continue to update you as we add more states.
If the patient who has Aetna or one of the BC plans does not agree to sign the patient letter please do not send that patients sample to MicroGenDX. Our policy with all other private plans has not changed with the exception that if the patients plan does not cover the cost of our test. They will receive an EOB (Explanation of Benefits) from their insurance provider and they will receive one invoice from MicroGenDX Laboratories.
Patient Billing Information
Your Doctor has requested testing by MicroGenDX Laboratory out of medical necessity. MicroGenDX a national laboratory that provides Molecular Diagnostic Testing. The DNA technology that MicroGenDX provides is the “gold standard” of microbial diagnostics.
After providing test results to your physician, MicroGenDX will bill most insurance companies for the testing. The insurance company will review the claim and determine your responsibility for deductible amounts and uncovered portions of the bill for each sample sent to the laboratory.
Please be advised, if contracted with MicroGenDX, your insurance will provide us the amount to bill you for the services rendered. This amount could vary depending on your plan deductible, coinsurance and/or copay, and may be higher than our discount offered to uninsured (self-pay) patients. If you have questions or concerns regarding your coverage, please contact your insurance company. We offer a discounted cash price of $199 for those patients whose insurance is not contracted with MicroGenDX. MicroGenDX is committed to insuring that all physicians and patients have a thorough understanding of our billing policies and have all necessary information. Our Customer Service Center is available for you to contact with any questions or concerns regarding your MicroGenDX bill.
MicroGenDX Customer Service:
1-855-208-0019, option 1
Billing Process for MicroGenDX Services
What to Expect:
- Upon Receiving the patient sample MicroGenDX (a Division of Southwest Regional Laboratories) verifies insurance information, completes testing and bills patient insurance plan.
- Insurance Providers will mail patients an Explanation of Benefits. Please Note an EOB (Explanation of Benefits) is NOT a bill from MicroGenDX.
- Please call the phone number on the back of your insurance card for information on coverage of this test.
- MicroGenDX offers a Patient Assistance Program which allows patients to pay in monthly installments until their balance is paid in full. Contact Customer Service at 1-855-208-0019 option #1 with additional questions or to begin a payment plan.
*If insurance provider sends check to the patient.*
PLEASE NOTE: Several BCBS and GHI Plans may send the check to the patient. Please write “Pay to the Order of MicroGenDX” and send that check directly to Southwest Regional PCR at 2002 W. Loop 289, Suite 116, Lubbock TX 79407.
- Insurance information was not received or the wrong insurance information was received on your test order
- The insurance carrier processed the claim and denied payment
- The insurance carrier processed the claim and applied the balance to your co-pay or deductible
- The insurance carrier did not respond to the claim
- If you’re using Internet Explorer 7.0 or later, the padlock is located at the top of your browser window, immediately to the right of the address bar.
- If you’re using Internet Explorer 6.0 or earlier, the padlock is located at the bottom right of your browser window, immediately to the left of the word "Internet".
- If you’re using Firefox 4.0 or later, you will not see padlock at all. Instead, the Site Identification Button is displayed on the left end of the address bar. If you’re using Firefox 3.0 or earlier, the padlock is located at the bottom right of your browser window.
- If you’re using Safari, the padlock is located at the top right of your browser window.
- Insurance information was not received or the wrong insurance information was received on your test order;
- The insurance carrier processed the claim and denied payment;
- The insurance carrier processed the claim and applied the balance to your co-pay or deductible;
- The insurance carrier did not respond to the claim.
- If you have insurance or not;
- Your insurance plan coverage of laboratory tests;
- Your age: if you are 65+, Medicare will not pay for some tests that your physician considers important; and
- Your healthcare providers agreement with MicroGenDX.