Natera billing

jmpark01

Has anyone experienced issues related to insurance and billing issues for genetic tests done with Natera? I just had a $3000 claim post to my insurance, which appears to not be covered at all, and am a little worried about the pending bill. My doctor said it should only cost me a few hundred, and Google searches imply there are a lot of billing issues with this company.  Does anyone have any recent experience?

bluejeanbabi05

Was it for the Panorama test, or something else? If it's Panorama, I can tell you that their billing dept told me the max they ever bill, even for selfpay, is $200. When you see something post to your insurance, that's just what the provider hopes to get in an ideal world. Don't freak out until you see the actual bill from the provider.

mrszoess

i called them and paid zero

bluejeanbabi05

@mrszoess for the Panorama test? How did you manage that? Was it covered by insurance?

delujm0

I called them before my test and they said they will attempt to put it through insurance up to 3 times, and if it gets denied that you should call them when you get their bill and they'll reduce it for you to somewhere in the $200-300 range.  I had the test done in November and I saw the insurance information come through to tell me that they had billed insurance something insane like $10k and that insurance was denying it - but Natera has yet to bill me, so I haven't called them back to have it reduced yet.  I wouldn't worry about it until you get a bill from Natera, and then if it's high, you should call them and ask for a reduction.

mrszoess

i had done it twice and both times they didn't get enough DNA in the sample, they tried to bill me and I told them heck no.

TW: I also used them for genetic testing after a d&C and they waived it. even if they don't totally cut down the payment, they'll charge you a hell of a lot less.

JennyColada

*Lurker*

Although not related to pregnancy, I have often have medical bills come in not fully covered by insurance. Generally I just call the medical billing department and ask them to resubmit to insurance. They really just want to get paid, they don't care who by. Often after they resubmit to insurance I "magically" owe less since insurance MAGICALLY paid more (funny how that works).

Really insurance is just trying to pay out the least that they think they can, so they try to lowball you in the hopes that you won't notice/care.

jmpark01

It was for the panorama test and I just checked and my insurance won't cover it.  I think there was confusion at my ob's office about what insurance plan I had, but they did say regardless of coverage I should only have to pay a few hundred. I was just surprised how much natera (tried) to bill my insurance. I'm glad to hear others have had similar experience. I definitely won't do anything until I get a bill but will definitely call them if it's high. 

delujm0

jmpark01 said:

It was for the panorama test and I just checked and my insurance won't cover it.  I think there was confusion at my ob's office about what insurance plan I had, but they did say regardless of coverage I should only have to pay a few hundred. I was just surprised how much natera (tried) to bill my insurance. I'm glad to hear others have had similar experience. I definitely won't do anything until I get a bill but will definitely call them if it's high. 

This is pretty standard - insurance generally only covers NIPT tests if you are AMA (over 35 on the due date) or otherwise labeled as high risk for genetic abnormalities.  The labs know this and still want to get paid SOMETHING for the tests, so if insurance denies them, they are willing to just get something out of you, even if it's a tiny fraction of what they attempted to bill your insurance.

 

I will literally turn 35 two days after my due date and insurance denied my claim.  I probably should have lied about my LMP to get them to bump my due date up...ha.  But it's still only $200-300, which I'm happy to pay for the peace of mind the test gave me.

Knottie37515447

Just received my EOB for $3k stating insurance pays $0 and was freaking out. This is for the Panorama test. Guess from your similar responses I will wait for actual bill. I will be 37 when baby is born and was told genetic test would be a total covered service with no out of pocket fee. 
Fingers crossed. This whole process is BS. 

bluejeanbabi05

Knottie37515447 said:

Just received my EOB for $3k stating insurance pays $0 and was freaking out. This is for the Panorama test. Guess from your similar responses I will wait for actual bill. I will be 37 when baby is born and was told genetic test would be a total covered service with no out of pocket fee. 
Fingers crossed. This whole process is BS. 

Don't wait for another bill. Call Natera and they will take care of it for you. Mine wasn't covered at all by insurance and it was $200. I also got that huge bill at first. Don't worry. 

caligal07

@Knottie37515447 - I'm in a similar situation as you. I did the Panorama test w/ microdeletions and when our EOB came, Natera billed our insurance company for $8,000!!! Our insurance only covered $300 and we haven't received a bill yet from Natera. It seems like $300 is the max people have been saying they had to pay OOP. I agree this whole process is BS. How can they charge insurance companies an insane markup like that and only a couple hundred dollars if you don't have insurance??? Had I known this, I would have bypassed insurance and just paid OOP.

Are you planning to contact Natera or wait for the bill to come first?