MicroGen DX 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.
MicroGen DX 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. MicroGen DX 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 MicroGen DX 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 MicroGen DX. 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 MicroGen DX Laboratories.
Patient Billing Information
Your Doctor has requested testing by MicroGen DX Laboratory out of medical necessity. MicroGen DX a national laboratory that provides Molecular Diagnostic Testing. The DNA technology that MicroGen DX provides is the “gold standard” of microbial diagnostics.
After providing test results to your physician, MicroGen DX 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.
Billing Process for MicroGen DX Services
What to Expect:
- Upon Receiving the patient sample MicroGen DX (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 is NOT a bill from MicroGen DX.
- MicroGen DX/DBA Southwest Regional PCR will send the patient a single statement reflecting your insurance plan’s final determination of benefits.
- No further collection efforts are made.
*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 MicroGen DX” and send that check directly to Southwest Regional PCR at 4321 Marsha Sharp Freeway #2, 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
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- 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 MicroGen DX.