PAYMENT OPTIONS

Patients should choose a payment option by checking the appropriate box on Myriad's Test Request Form (pdf). If the Insurance Billing option is selected, the patient's signature is also required. The Test Request Form is available in every test kit or by calling Myriad Customer Service at 1-800-469-7423, option "0." Healthcare providers may also request a test kit using our online order form.

Payment options are outlined below:

Option 1 — Insurance Billing
Myriad will bill the insurer for services rendered. Testing will begin upon receipt of the blood sample, completed Test Request Form (with patient signature), and legible photocopies of the front and back of the patient's insurance card. Myriad will submit bills directly to insurance carriers and will appeal and resubmit claims if necessary. Some insurance companies pay up to "usual and customary" amounts. These amounts vary and may or may not cover the entire charge for the test. Any difference between the total charge and the insurance payment will be billed to the patient.

Option 2 — Patient Payment
Patient pays for the testing service themselves. The patient may provide credit card information on the Myriad Test Request Form or may provide a check or money order payable to Myriad Genetic Laboratories, Inc. for submission in the test kit together with the blood sample. A patient may also contact Customer Service for installment payment options.

TheraGuide 5-FU™ Patient Protection Program
For a limited time, Myriad Genetic Laboratories, Inc. will be offering a TheraGuide 5-FU™ Patient Protection Program. The Patient Protection Program was developed to protect patients undergoing chemotherapy from unexpected financial liability due to limited insurance coverage during the introduction of TheraGuide 5-FU™.

Qualifying patients* for whom TheraGuide 5-FU™ has been performed may be eligible for the program. The patient will continue to be responsible for applicable deductible and copayment amounts according to their health plan. However, the out-of-pocket costs will be limited to the greater of: the patient's applicable deductible and/or co-payment OR 20% of Myriad's billed charges.

Eligibility:
To participate, qualifying patients* who opted for Insurance Billing as described above may, after receiving an invoice from Myriad, contact Myriad's billing department at the toll-free number that appears on the invoice (1-800-725-2722) to complete a program application. In the case of an insurance denial, the patient must agree to cooperate with Myriad's appeal to the insurance company for coverage.

  • A qualifying patient is one who is being considered for, or is currently receiving, 5-FU therapy as a result of a cancer diagnosis, is a member of a private health insurance program, and resides in a jurisdiction where such a program is not prohibited by law. Patients covered under Medicare, Medicaid or other government program, or who reside in Florida, Massachusetts, Texas, Minnesota, Rhode Island, or other state where such a program is prohibited are not eligible for the Patient Protection Program.

Letters of Medical Necessity

Some insurance companies require that a letter of medical necessity (LMN) be submitted prior to granting pre-authorization. Examples of an LMN can be viewed by clicking the following link:

Medicare
Medicare has not established coverage policy for this test. For Medicare patients, an Advance Beneficiary Notice of Noncoverage (ABN) is required before testing will begin. Because Medicare will likely not cover test costs until policy has been established, test costs will be billed to the patient. A summary of instructions and documentation requirements for Medicare patients is included on page one of the Advance Beneficiary Notice of Noncoverage.

You can download the Advance Beneficiary Notice of Noncoverage (including Medicare information) and the Informed Consent Form by clicking on the links below. Alternatively, the forms can be mailed to you by calling the Customer Service Department at 1-800-469-4723.

Advance Beneficiary Notice of Noncoverage (pdf)
Informed Consent Form (pdf)

Myriad Financial Assistance Program
Myriad is able to offer testing at no charge to uninsured patients that meet specific financial and medical criteria. Patients who are recipients of government-funded programs (i.e. Medicaid, Medicare) or those that have any third-party insurance are not eligible to apply.

Qualification requirements and the submission instructions are provided below:

To view the current HHS financial guidelines, please view the link below.
http://aspe.hhs.gov/poverty/index.shtml

* To view PDF files, you need the free Adobe Acrobat Reader software.



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