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BRACAnalysis® can only be ordered by a qualified healthcare provider.
Testing for cancer risk is covered by most insurance companies. To learn more about payment, insurance, and your privacy rights, click on the links below.
Most insurance carriers cover genetic testing services. Although each situation is unique, the average patient pays only 10% of the test price out-of-pocket. The Myriad Reimbursement Assistance Program (MRAP) can help you navigate health insurance billing and reimbursement issues.
How it works: Your doctor documents certain key ancestry and personal history information and designates the appropriate test for you on Myriad's Test Request Form. On the same form, you choose a payment option by checking the appropriate box. If you select an insurance billing option (Option 1 or Option 2), you'll need to sign the form.
Before starting the test, Myriad will verify coverage with your insurer. After Myriad receives a completed and signed Test Request Form authorizing Myriad to contact your insurer, as well as legible photocopies of the front and back of your insurance card with your blood sample, Myriad specialists will:
If the insurer reports that no out-of-pocket expense is expected, the test will be started.
If any out-of-pocket expense is required, a Myriad Patient Services Coordinator will call you with insurance coverage information before starting the test.
Some insurers may require a preauthorization before the sample is submitted for testing, which may delay the start of the test. Your doctor can call Myriad Customer Service regarding how to submit benefit determination requests before submitting the sample.
Myriad will submit bills directly to insurance carriers and will appeal and resubmit claims if necessary.
Note: Medicare patients should select Option 1.
Myriad will bill the insurer for services rendered. Testing will begin upon receipt of the blood sample, completed Test Request Form, and legible photocopies of the front and back of your insurance card. Some insurers may not pay for testing without preauthorization.
Myriad will submit bills directly to insurance carriers and will appeal and resubmit claims if necessary. Any difference between the total charge and the insurance payment will be your responsibility.
Pay for the testing service yourself. With your sample, you provide credit card information or a check or money order payable to Myriad Genetic Laboratories, Inc. for the full amount of the test. Contact Customer Service for installment payment options.
If you cancel a test before it is started, you will not be charged. If your case is other than an Option 1 case, the test is usually started 24 to 48 hours after receipt at Myriad. For Option 1 cases, test start is dependent upon insurance benefit determination (see description of Option 1 above). Once your test is started, you are responsible for payment of the test.
Medicare patients should select Option 1. Medicare pays for the test when specific criteria are met. Your physician should consult Medicare's Web site to determine if you meet Medicare's criteria for genetic testing, and she or he can obtain assistance in interpreting the criteria from Myriad's Medical Services at (800) 469-7423. For patients who do not meet Medicare criteria, a signed Advance Beneficiary Notice (ABN) and signed informed consent is required to be received by Myriad before testing will begin. Because Medicare will likely not cover test costs for patients who do not meet Medicare criteria, test costs will be billed to you.
We will never disclose your test results to anyone else, including your insurance carrier, without your written permission. We disclose your test results only to the requesting doctor/designee.
Federal and state laws prohibit health insurance discrimination against patients who undergo genetic testing. In 1996, the federal government enacted the Health Insurance Portability and Accountability Act (HIPAA). Under this law, patients in group health insurance plans are protected from discrimination based on genetic information.
Studies have found no documented cases of health insurance discrimination on the basis of genetic testing for hereditary cancer syndromes. Most states have enacted laws further protecting patients from discrimination based on genetic information.
Your genetic test results are strictly confidential, and will only be released to the doctor who ordered your test, unless you provide written consent specifying otherwise. Even when your insurance company pays for your genetic test, the company does not receive your results.
Here are some helpful Web sites that will give you more information on your privacy rights:
National Conference of State Legislatures
www.ncsl.org
United States Department of Health and Human Services, Office for Civil Rights
www.hhs.gov/ocr
National Human Genome Institute—The Ethical, Legal and Social Implications (ELSI) Research Program
www.nhgri.nih.gov/ELSI
National Institutes of Health—Office of Legislative Policy and Analysis
http://olpa.od.nih.gov
The Library of Congress—THOMAS
http://thomas.loc.gov/home/thomas.html
American Civil Liberties Union
www.aclu.org
Georgetown University Health Policy Institute
www.healthinsuranceinfo.net
The Health Insurance Portability and Accountability Act (HIPAA), enacted by Congress in 1996, required the Department of Health and Human Services to establish national standards for electronic healthcare transactions and national identifiers for providers, health plans, and employers. In addition, HIPAA also contains provisions that address the security and privacy of health data and information.
Myriad is dedicated to offering high-quality laboratory services in the area of predictive medicine and is committed to ensuring patient privacy through compliance with HIPAA. We have an active privacy program that ensures your confidentiality and is fully compliant with the HIPAA Privacy Rule.
As mandated by the Privacy Rule, Myriad requires that all employees undergo privacy awareness training and has implemented administrative and technical safeguards that are focused on protecting patient privacy. Myriad is also committed to compliance with the HIPAA Security and the Transactions and Code Sets regulations prior to their respective compliance deadlines.
The HIPAA Privacy Rule gives you the right to be informed of our privacy practices and your privacy rights where they concern your personal health information. You can download our Notice of Privacy Practices in PDF format here [PDF–Size: 92KB]. If you prefer to receive a copy by mail, call the Customer Service Department at (800) 469-7423.
Questions
Please direct general questions about Myriad services to our Customer Service Department at (800) 469-7423.
Complaints
Please direct complaints concerning privacy or confidentiality to our Quality and Compliance Department, Privacy Office at (800) 883-3263, or by email at quality@myriad.com.
