Baylor Genetics is in-network with many insurance companies, and more than likely, we’re in-network with yours, too. Click on the “In-Network Plans” tab below to find out.
To find out your estimated out-of-pocket costs:
- Contact your physician to fill out the Patient Insurance Benefit Verification Form.
- Out-of-pocket cost varies based on your individual
- Your physician will submit the form to Baylor Genetics for verification.
- Once verification is complete, our team will contact you and your physician to discuss the estimated out-of-pocket cost, payment options, and financial assistance, if requested.
Cash pricing is available when insurance is not an option. Please contact us for pricing questions at 1.866.848.4228.
Pay My Bill
Use our online Payment Portal to make a payment or pay for testing ahead of time.
If you would like to send payment along with your sample, we accept the following:
- Checks / Money orders (Payable to Baylor Genetics)
- Wire Transfers
- Aetna HMO*
- Aetna Elect Choice
- Aetna QPOS
- Aetna Select
- Aetna Managed Choice POS
- Aetna Choice POS II
- Aetna Open Access Student MC
- Aetna Signature Administrators
- Aetna Joint Claims Administration
- Aetna Passport to Healthcare
- Aetna PPO
- Aetna National Advantage
- Aetna National/First Health Network
- AmeriGroup Kansas
- AmeriGroup Texas
- Anthem California
- Anthem Connecticut
- Anthem Georgia
- Anthem Indiana
- Anthem Kentucky
- Anthem New England
- Anthem New Hampshire
- Anthem Missouri
- Anthem Ohio
- Anthem Virginia
- Anthem Wisconsin
- BeechStreet – PPO
- BlueCross BlueShield of Arizona
- BlueCross & BlueShield TX Blue Essentials HMO*
- BlueCross & BlueShield TX PAR Indemnity
- BlueCross & BlueShield TX Health Select
- BlueCross & BlueShield TX PPO – Blue Choice
- BlueCross & BlueShield of Illinois PPO
- CIGNA HMO*
- CIGNA PPO
- Community Health Choice – Community Marketplace
- Harvard Pilgrim Health Care
- Health Spring-Renaissance IPA
- Humana Commercial PPO
- Humana HMO*
- Humana POS
- Humana EPO
- Humana HMO Premiere*
- Humana Choice Care Commercial PPO
- Humana Choice Care POS
- Humana Military – Tricare*
- (New Tricare East, including North and South regions)
- Mail Handlers Benefit Plan
- Maine Community Health Option
- Memorial Hermann Health Solutions Inc. Choice
- Memorial Hermann Health Solutions Inc. EDGE
- Memorial Hermann Health Solutions Inc. PPO
- Molina Health Care of Texas HMO
- OSU Health Plan
- Ped-I-Care (Florida)
- Physicians Health Plan of Northern Indiana (PHPNI)
- POMCO [Government]
- Scott & White Health Plan HMO
- Scott & White Health Plan PPO
- Seton Health Plan PPO
- Seton Health Plan EPO
- Stratose [Network]
- SummaCare Ohio
- Texas Children’s Health Plan
- Texas Health and Human Services [Government]
- Three Rivers Provider Network
- United Healthcare [Commercial]*
- United Healthcare Empire Plan (New York)
- Wellmark Iowa
- Wellmark South Dakota
The Medicaid policies listed below require prior authorization by an ordering provider.
Effective immediately, TX Medicaid and TX Managed Medicaid will no longer process prior authorizations or provide reimbursement for testing that is non-covered by the TX Medicaid fee schedule.
Examples include 81415, 81416, 81479, 81228, 81229, 81460, and 81465, which primarily affect Whole Exome Sequencing (WES), Chromosomal Microarray Analysis (CMA,) Comprehensive Mitochondrial Analysis, and any testing coded with 81479.
Always double check the most recent TX Medicaid fee schedule before requesting a prior authorization.
- BlueCross & BlueShield TX CHIP
- BlueCross & BlueShield TX STAR
- BlueCross & BlueShield TX STAR Kids
- Community Health Choice Inc. CHIP
- Community Health Choice Inc. STAR
- Cook Childrens Health Plan CHIP
- Cook Childrens Health Plan STAR
- Dell Children’s Health Plan CHIP
- Dell Children’s Health Plan STAR
- Molina Health Care of Texas CHIP
- Molina Health Care of Texas STAR
- Molina Texas Medicaid STAR+PLUS
- Scott & White HealthPlan Medicaid CHIP
- Seton Health Plan STAR
- Seton Health Plan CHIP
- Superior HealthPlan CHIP
- Superior HealthPlan Medicaid
- Superior HealthPlan STAR
- Superior HealthPlan STAR Kids
- Superior HealthPlan STAR Health
- Superior HealthPlan STAR+PLUS
- UnitedHealthcare Community Plan of Texas
- New Mexico
- New Jersey
- New York
- North Carolina
- South Carolina
We are a certified Medicare provider. The patient must meet Medicare’s specific testing criteria for genetic tests. A completed Advanced Beneficiary Notification (ABN) form is required if the patient does not meet the criteria.
*Requires prior authorization by an ordering provider.
- The deductible is the amount you pay each year for health care services before your health insurance begins to cover the costs.
- Co-insurance is the percentage of costs your health insurance covers for the service after your deductible is paid. For example: If your health insurance pays 80% of the claim, you will pay the 20% remaining.
- Co-payment is the fixed amount you pay for a covered service before you receive services from your physician.
- The allowable charge is the dollar amount considered by your health insurance company to be a reasonable charge for medical services based on the rates in your area.
- An Explanation of Benefits (EOB) is the health insurance company’s written explanation of how a medical claim was paid. It contains detailed information about what the insurance company paid and what portion of the costs you are responsible for paying.
- Current Procedural Terminology (CPT) is a medical code system maintained by the American Medical Association that is used to report medical, surgical, and diagnostic procedures and services to entities such as physicians, health insurance companies, and accreditation organizations.
- ICD-10 refers to the 10th revision of the International Statistical Classification of Diseases and Related Health Problems (ICD), a medical classification list by the World Health Organization (WHO). It contains codes for diseases, signs and symptoms, abnormal findings, etc. CPT codes are used in conjunction with ICD-10 codes during the health insurance billing process.
Is my insurance plan in-network?
We are in-network with many plans. You can find our full list of in-network health plans on the “In-Network Plans” tab.
How is my out-of-pocket determined?
If you plan to file an insurance claim, our verification team will perform a benefit investigation to help determine your out-of-pocket cost, upon request by your physician. Out-of-pocket can be the deductible, co-pay, or co-insurance amount as specified by your health plan. If you would like to know your out-of-pocket cost please have your physician fill out this form.
Your estimated out-of-pocket will be determined by the following factors:
- Your personal insurance plan
- Test ordered
- Estimated reimbursement
- Insurance plan’s contracted rates
Will my test be covered?
Coverage will be based on various factors including the following:
- Medical necessity
- Health plan’s medical policies
- Insurance benefits provided
What if insurance does not cover my test?
Our verification team can verify benefits prior to your test being ordered by request of your physician. If insurance will not cover your test, we offer Self-Pay options as well as Financial Assistance to eligible households.
How much will this cost me?
Baylor Genetics is committed to working with our patients to make genetic testing accessible. We know how difficult it can be to cover the costs related to genetic testing, and our team is here to help you.
The individual cost will depend on various factors. You may contact our billing team directly by calling 1.866.848.4228, or contact us for pricing questions.
When can I expect my bill?
If Insurance is filed, and you are responsible for any cost, you should expect to receive a bill in 4-6 weeks.
If you opt for our Self-Pay option, you will be billed after your test is reported.
What is an Explanation of Benefits? Is this my bill?
An Explanation of Benefits (EOB) is not a bill. An EOB is a statement sent by your insurance company explaining what medical treatments and/or services were covered by your plan.
Can I pay my bill online?
Yes, you can pay online using our secure Payment Portal with any major credit card.
Do you offer discounts, payment plans, or financial assistance?
Baylor Genetics is committed to providing you with support when our patients experience financial burden.
Please call us to discuss discounts, interest-free payment plans, and finding out more about our financial assistance program.*
* Financial assistance is based on the Federal Poverty Income Sliding Scale. Combined household income must be less than or equal to four times the federal poverty guidelines. This is based on the HHS Poverty Guidelines. Restrictions may apply.