GENOVA DIAGNOSTICS BILLING INSTRUCTIONS

Step 1:

Determine whether you are EasyPay Schedule A or Schedule B based on your insurance:

EasyPay Schedule A

Patients should select this option if:

  • You have private or commercial health insurance coverage AND your insurance plan does not appear on our EasyPay Schedule B list below
  • OR you are a Medicare Advantage subscriber AND your insurance company does not appear on our EasyPay Schedule B list below
  • OR Genova Diagnostics is an in-network provider for your insurance plan

EasyPay Schedule B

Patients should select this option if:

  • You do not have health insurance coverage

  • OR you receive health insurance coverage from one of the following EasyPay Schedule B-eligible insurance companies or plans listed below:

    • Aetna

    • Humana

    • Principal

    • Kaiser

    • Tufts

    • Blue Cross Blue Shield (BCBS) of North Carolina – All BCBS members are eligible, but ONLY when receiving services from health care practitioners in North Carolina

    • BCBS Federal Employee Program (FEP) – All FEP members are eligible EXCEPT when Genova Diagnostics is an in-network provider. When this is the case, FEP members should use our Schedule A option instead. Please refer to BCBS Federal Employee Program section below for more details.

Step 2:

Determine the cost for your specific test based on your EasyPay Schedule by looking up your test here.

Step 3:

Confirm that your health care practitioner has provided all necessary information. The following information is needed in order for us to file an insurance claim on your behalf: Completed requisition form (with ICD-9 diagnosis coding noted) Health care practitioner’s National Provider Identifier (NPI) entered on the requisition form

Step 4:

Submit insurance information on the requisition form with a copy of the front and back of your insurance card.

Other Program Details and Requirements:

If you receive payment directly from your 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 your total amount due and you will be billed for outstanding deductibles, co-payments or coinsurance under the EasyPay billing guidelines.

  • Failure to forward payment and EOB will result in your removal from the EasyPay billing program.

You may be required to provide a copy of the EOB from your 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 his/her test.

For more information please visit the Genova Diagnostics Website