Billing
Fair, affordable, and CLEAR
Our goal is to treat every patient as an in-network patient by offering fair, affordable pricing to our payor partners and their patient members. Next Genomix’s CLEAR Pricing Program offers benefits to In-Network, Out-Of-Network (OON), and Cash-Pay patients.
Billing Options
In-Network
Cash-Pay Patients
Out-of-Network
In-Network
Next Genomix partners, as an in-network laboratory, with many of the large health insurance companies and federal and state insurance plans. These include Medicare, state Medicaid plans, Managed Medicaids, many BCBS affiliates, and other national and regional plans. For a list of current network agreements, please consult our website or call 833.922.4NGL (4645), option 2, to speak with a Patient Advocate.
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Like your physician, as an in-network provider, Next Genomix must bill patients for any co-payments or deductibles as specified in your member agreement with your health insurance plan.
Cash-Pay Patients
For patients wishing to pay cash for lab testing, because our sophisticated testing may be a non-covered service with their insurance plan, may be self-insured or with a high deductible, but chose not to bill their insurance, Next Genomix offers affordable Cash Payments, accompanied with an early payment discount. Cash Payment arrangements must be made with Next Genomix within three (3) business days of receipt of a specimen to allow for timely processing.
Out-of-Network
In the rare instance that Next Genomix is OON with your insurance plan, with CLEAR Pricing, you will be billed as an in-network patient. Depending on the medically necessary testing determined by your medical provider, your co-pay will be equal to the average estimated co-pay of an in-network patient. These amounts are updated biannually. As with any health insurance claim, you must provide evidence of current coverage.​
Once results are returned to your provider, Next Genomix will submit a claim to your insurance company for processing and a bill to you for the CLEAR Pricing OON Co-Pay for payment within 14 days.
EXAMPLES OF COMMON TESTS
Financial Assistance
NGL is committed to providing medically necessary testing to all
Our Financial Assistance Plans align with the need to assist those whose medical bills, including laboratory testing, result in a financial hardship, based upon their inability to pay, while providing for themselves and their families.
MEDICAL FINANCIAL HARDSHIP
Using the HHS 2024 Federal Poverty Guidelines below, Next Genomix will provide financial hardship discounts for balances due, where not prohibited by law, as follows:
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With Documented Income at or Below 100% of the Federal Poverty Guidelines, the patient will pay $0 balance for testing performed.
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With Documented Income at 101% or below 150% of the Federal Poverty Guidelines, the patient will pay $0 balance for testing performed.
2024 Poverty Guidelines for the 48 Contiguous States and the District of Columbia:
PATIENTS MUST PROVIDE DOCUMENTED PROOF OF FINANCIAL HARDSHIP BY THE FOLLOWING:
Complete the Next Genomix Medical Financial Hardship Plan Application
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Provide one of the following for documentation on record:
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Recent tax year's W-2 or other evidence of income (1099, etc)
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Recent tax year's IRS form 1040
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Two most recent pay stubs
In the case where a patient requires time to pay their balance due medically necessary testing performed by Next Genomix, our affordable payment plan allows for equal payments over a period of up to three (3) months. This requires a credit card on file to facilitate automatic payments on the agreed upon date when the payment plan is in place. Contact our Patient Advocate for further details.
833-922-4NGL (4645)