Patient Payment Options

EasyPay Program and Insurance


EasyPay

EasyPay Program Overview


The EasyPay Insurance Billing Program is the option for patients with private or commercial insurance, including Medicare Advantage plans.

The EasyPay Insurance Billing Program offers numerous benefits, including the following:

  • Genova submits the claim to your insurance carrier and manages the claims adjudication process for you!
    • No claim forms or insurance ready statements for you to handle.
  • Helps patients manage out-of-pocket expenses
  • Flexible and affordable payment options are available

Our EasyPay program offers two options, which are distinguished as Schedule A and Schedule B. Patients are required to make either the EasyPay Schedule A or Schedule B amount along with their test in order to participate in our insurance billing program.

If you have a Genova Diagnostics collection pack, visit the MYGDX Patient Resource Center to use our online billing tool which helps you determine payment amounts or follow the four steps outlined below:

Step 1 – Determine EasyPay Schedule A or B Eligibility
Schedule A

  EasyPay Schedule A

Patients are eligible for EasyPay Schedule A if:

  • The patient has private or commercial health insurance coverage AND their insurance plan does not appear on our EasyPay Schedule B* list below
  • OR the patient is a Medicare Advantage subscriber and their Medicare Advantage Plan is not covered by the EasyPay B insurance companies listed below
  • OR Genova Diagnostics is an in-network provider for the patient's insurance plan

Schedule A

  EasyPay Schedule B

Patients are eligible for EasyPay Schedule B if:

  • The patient does not have health insurance coverage, or chooses not to file insurance
  • OR the patient receives health insurance coverage, including a Medicare Advantage Plan, from one of the following EasyPay Schedule B insurance companies or plans listed below:
    • Aetna
    • Humana
    • Principal
    • Kaiser
    • Tufts
    • Blue Cross Blue Shield (BCBS) for select tests when the healthcare practitioner is located in New Jersey
    • Blue Cross Blue Shield (BCBS) when the healthcare practitioner is located in North Carolina
    • BCBS Federal Employee Program (FEP) for select tests. Please refer to the BCBS Federal Employee Program section below for more details.

*Schedule B allows for a payment plan option to be selected on certain tests and requires 40% with specimen submission.

Step 2 – Submit Payment with the Test Requisition

The EasyPay Schedule A or B* payment amount and the proper test requisition form must accompany the specimen. Convenient and secure payments for EasyPay Schedule A and B can be made by patients at the MYGDX Patient Resource Center.

Schedule A

  EasyPay Schedule A

  • EasyPay Schedule A payments should be paid in full.

Schedule A

  EasyPay Schedule B

  • EasyPay Schedule B payments may be paid in one of two ways:
    • Full Pre-payment
    • Payment Plan – For qualifying tests, priced at $200 or higher, the initial payment is 40% of the EasyPay Schedule B price. The remaining amount due will be charged in up to 3 equal installments. There is a one-time fee of $10 to participate in a Payment Plan that will be billed on the patient's next installment.

*Schedule B allows for a payment plan option to be selected on certain tests and requires 40% with specimen submission.

Step 3 – ICD-10 Diagnosis Code Requirement

Confirm that there is an ICD-10 diagnosis code(s) noted on the front of your requisition (this information is provided by your healthcare practitioner).

Step 4 – Include Insurance and Patient Information

Submit insurance information and patient information, including name and address, on the requisition form.

Patients participating in the EasyPay program must provide insurance information and have active coverage on the date they collect their specimen in order for Genova Diagnostics to file their claim.

EasyPay Schedule Guidelines

Other Program Details and Requirements

Once your insurance carrier processes the claim, the patient will be sent statements detailing all payments, adjustments, and remaining patient responsibility amounts, including denials.

If the patient receives payment directly from their insurance company, then the payment and a copy of the Explanation of Benefits (EOB) must immediately be forwarded to Genova Diagnostics.

  • When payment is received it will be applied toward the total amount due and the patient will be billed for outstanding deductibles, co-payments or coinsurance under the EasyPay billing guidelines.
  • Failure to forward payment and EOB will result in removal from the EasyPay billing program.

Patients may be required to provide a copy of the EOB from their insurance provider in order to be eligible for the EasyPay program.

In order to substantiate medical necessity for testing and to be eligible for insurance reimbursement, health care practitioners may be required to provide medical records to insurance companies. Failure of a health care practitioner to provide this information in a timely manner may result in the patient being billed for the total list price of the test.

If any of the items above are not provided, the patient could be responsible for up to the list price of the test minus payment received by Genova Diagnostics.

When Do We Apply Payment?

  • For patients with non-contracted insurance: Genova Diagnostics applies the payment prior to submitting to insurance
  • Contracted insurance and Medicare Advantage: Genova Diagnostics applies the payment after insurance processing, if applicable

Health Reimbursement Accounts (HRAs) and Health Savings Accounts (HSAs) and High Deductible Health Plans

Patients with high deductible plans with health reimbursement accounts should consider paying the EasyPay Schedule B amount to prevent substantial deductions from their HRA/HSA account. Please do not include insurance information if choosing this option.

Patients not submitting insurance will receive an itemized statement to submit reimbursement from their insurance carrier or health reimbursement account.

Medicare, Medicaid, and Tricare (Government Programs)

Patients who have Medicare, Medicaid, and/or Tricare are not eligible for our EasyPay Insurance Billing Program.

If primary insurance coverage is through Medicare, Medicaid, or Tricare, visit our Medicare Guidelines page for more information.

TOP ↑


Genova Diagnostics

Genova Diagnostics as an In-Network Provider


Genova Diagnostics is an in-network provider for a growing list of insurance companies. We submit claims to these insurance companies on behalf of patients, when insurance billing is indicated as the patient's preferred payment method. These patients should utilize our EasyPay Schedule A option.

If we are an in-network provider for a patient's insurance or Medicare Advantage plan, the EasyPay Schedule A amount will be applied towards their total amount due, as indicated on the EOB provided by their insurance provider.

We are In-Network Providers for the Following Insurance Companies (as of 11/01/17)

  • Highmark Blue Cross and Blue Shield – when receiving services ordered by a Pennsylvania or West Virginia health care practitioner only. This includes the following programs:
    • Highmark Blue Shield
    • Keystone Health Plan WEST – Medicare Advantage
    • Freedom Blue – Medicare Advantage
    • Secure Blue HMO – Medicare Advantage
    • BCBS of Northeastern Pennsylvania
    • Pennsylvania Independence Blue Cross
    • Out of state BCBS members receiving services ordered by health care practitioners in Pennsylvania

      Other Pennsylvania Blue Cross and Blue Shield plans are NOT included in our Highmark contract, so we are therefore out-of-network for:
    • First Priority Health
    • First Priority Life
    • Keystone Health Plan EAST
    • Personal Choice
    • Independence Administrators
    • Capital BlueCross of Pennsylvania

However, these plans are included in EasyPay Schedule A.

  • CareFirst Blue Cross Blue Shield:
    • Blue Cross and Blue Shield members, including Federal Employee Program, receiving services ordered by HCPs that reside in MD, DC and Northern VA. ONLY
    • CareFirst BCBS HMO products identified with prefixes XIC, XIK, XWR, XIR are not contracted. For these plans, we are considered out-of-network; however, these plans are included in Schedule A
  • Blue Cross and Blue Shield of Kansas City – Blue Cross and Blue Shield patients, including out of state BCBS members receiving services in the Blue Cross and Blue Shield of Kansas City service area in Missouri and Kansas ONLY
  • Blue Shield of California – BCBS patients, including out-of-state BCBS members, receiving services from health care practitioners in California ONLY
    • Not Eligible: Anthem Blue Cross of CA members are non-participating, but are eligible for the EasyPay Schedule A program
  • Blue Cross and Blue Shield of Illinois – PPO products and all out-of-state members receiving services from a health care practitioner in Illinois ONLY

TOP ↑




Blue Cross Blue Shield Federal Employee Program (FEP)

Blue Cross Blue Shield Federal Employee Program (FEP)


Patients will be required to provide either the EasyPay Schedule A or Schedule B* amount with their collection pack submission, based on which test they are submitting and where their physician is located.

Patients should provide EasyPay Schedule A if:

  • They are submitting one of these tests on page 2 of the Blue Cross Blue Shield Federal Employee Program (FEP) Handout.
  • OR if they are not submitting a test above, but their physician is located in the CareFirst Blue Cross and Blue Shield service area (MD, DC, Northern Virginia). Genova Diagnostics is contracted with BCBS FEP, but only in this area.

Patients should provide EasyPay Schedule B if:

  • They are submitting a test not listed above AND their physician is located outside of the CareFirst Blue Cross and Blue Shield service area (MD, DC, and Northern Virginia)

*Schedule B allows for a payment plan option to be selected on certain tests and requires 40% with specimen submission.

TOP ↑