Insurance Resources
Diagnostic Cytogenetics, Inc. has over 40 years of expertise in billing for cytogenetics, offering both direct institution and third party insurance billing according to client preference.
For any billing-related inquiries, please contact our billing service PGM at 888-336-8283 ext267.
Preauthorization
Due to changes in reimbursement climate, Diagnostic Cytogenetics Inc. will now be requesting our clients to submit preauthorization for samples billed to insurance, with the exception of Medicare.
Because we know that these results are critical for patient care, DCI will NOT require approval of preauthorization before testing is performed. The outcome of the preauthorization (approval/denial) will also not affect processing, testing, and reporting of your specimens in any way. It is important to us that your patients get the results that they need.
For chromosome analysis:
The following insurance providers require preauthorization:
-Community Health Network of Washington
-Coordinated Care
-Kaiser Permanente/Group Health
-United Healthcare: Healthy Options, Blind+Disabled, and AppleHealth policies only
-Washington State DSHS Provider One
For FISH testing:
The following insurance providers require preauthorization:
-Community Health Network of Washington
-Coordinated Care
-Kaiser Permanente/Group Health
-Molina Healthcare of WA (neoplastic cases only)
-United Healthcare: Healthy Options, Blind+Disabled, and AppleHealth policies only
-Washington State DSHS Provider One
Directions
Before a specimen is sent to the lab, we ask that the appropriate preauthorization form be completed and faxed to the insurance company along with a clinical chart note supporting the medical necessity for testing. Please also include a copy of the preauthorization form with the paperwork sent to DCI, if possible.
Forms
To assist our clients in this process, DCI has collected the following preauthorization forms for specific insurance providers that have DCI’s information and CPT codes completed:
-Community Health Network of Washington
Community Health Plan of WA Preauth- Neoplastic
Community Health Plan of WA Preauth- Solid Tumor
-Coordinated Care
Coordinated Care Preauth- Neoplastic
Coordinated Care Preauth- Solid Tumor
-Lifewise
-Molina Healthcare of WA (only required for FISH cases)
-United Healthcare Community Plan