Insurance Resources

Diagnostic Cytogenetics, Inc. has over 36 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 specialist Lauren Dreste at 800-328-2026 or Lauren@diagnosticcytogenetics.com.

 

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 CPT codes used for FISH have changed effective January 2015.  Until we can gather information on reimbursement for the new code 88377, we ask that preauthorization be submitted for all samples sent for FISH testing that are billed to insurance, with the exception of Medicare.

 

 

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 created the following universal preauthorization forms for our services:

DCI Preauthorization Form for Constitutional Specimens

DCI Preauthorization Form for Neoplastic Specimens

 

The following are 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- Amnio

Community Health Plan of WA Preauth- Peripheral Blood

Community Health Plan of WA Preauth- Fetal/Solid Tissue

Community Health Plan of WA Preauth- Neoplastic

Community Health Plan of WA Preauth- Solid Tumor

-Coordinated Care

Coordinated Care Preauth- Amnio

Coordinated Care Preauth- Peripheral Blood

Coordinated Care Preauth- POC/Solid Tissue

Coordinated Care Preauth- Neoplastic

Coordinated Care Preauth- Solid Tumor

-Lifewise (only required for FISH cases)

Lifewise Preauth- FISH

-Molina Healthcare of WA (only required for FISH cases)

Molina Preauth – FISH

-United Healthcare Community Plan (only required for FISH cases)

United Healthcare Community Plan Preauth- FISH

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