• Clinics, hospitals, laboratories, and physicians may establish an institutional billing account with convenient monthly invoicing and payment options.
• Complete billing information must be indicated in the order (step 2 of the order on the Nucleus platform) when samples are submitted.
• Blueprint Genetics offers institutional clients the opportunity to improve laboratory utilization management and compliance through our laboratory services agreements.
• For questions about establishing an institutional billing account please contact our billing support at 650.452.9340 Ext. 1 or billing.us@blueprintgenetics.com.

• Blueprint Genetics works with all commercial insurances and every patient with active benefits can access our diagnostic testing service. We work closely alongside the patient and their clinician to obtain the maximum insurance reimbursement.
• Blueprint Genetics will perform a benefit investigation once a test order is received with commercial insurance checked off on the test requisition, a copy both sides of patient’s insurance card attached, and patient demographic information filled out.
• One of our billing specialists will contact the patient or family (normally within 72 hours after receipt of sample) and inform them of their out-of-pocket costs, considering any unmet deductible, co-pay, and co-insurance.
• Blueprint Genetics’ billing specialists will provide prior authorization concierge support for the clinician and patient before the sample is drawn when possible. Additionally, we can assist clinicians with submitting letters of medical necessity (LOMN) and supporting clinical documents. Blueprint Genetics complies with all appropriate statutes and rules governing insurance billing and claims for reimbursement.
• We will forward the appropriate notification of obligation to the patient as specified by the Explanation of Benefits (EOB). In all instances, Blueprint Genetics will adhere to the terms of the patient’s individual policy insofar as payments for services are concerned. Patients should check with their local provider or insurance provider for preauthorization and coverage questions related to our services.
• Patients with a commercial insurance plan for which Blueprint Genetics is a contracted provider are subject to the deductible, coinsurance, or co-pay obligations of their plan.
• If the patient is not completely satisfied with our billing solution, there is no obligation to move forward with testing. If the patient decides to cancel the test, we will contact the ordering physician to get their approval before cancellation.

[In-Network Commercial Insurance]

The following insurance plans are in-network:

• Aetna®
• Anthem® Blue Cross® California
• Anthem® Blue Cross® Blue Shield® Connecticut
• Anthem® Blue Cross® Blue Shield® Maine
• Anthem® Blue Cross® and Blue Shield® New Hampshire
• Blue Cross® and Blue Shield® of Massachusetts
• Blue Cross® and Blue Shield® of New Mexico
• Cigna®
• Federal Blue Cross Blue Shield
• Harvard Pilgrim Health Care
• Horizon® Blue Cross® and Blue Shield® of New Jersey

[Out-of-Network Commercial Insurance]

Blueprint Genetics accepts all commercial insurance plans; however, we do not have contracts with all commercial insurance plans. We will file claims and appeals with a patient’s insurance plan. Blueprint Genetics will bill the patient for any charges not paid by the insurance.

For plans that send payment directly to their members (including many BCBS plans), the patient must agree, that if they receive payment from their insurance carrier for Blueprint services, they will endorse the check and send it to: 200 Forest Street, 2nd Floor Marlborough, MA 01752

• Blueprint Genetics offers a self-pay option for patients with commercial insurance policies that are structured with extraordinarily high deductibles or restrict access to the specialty genetic testing services provided by Blueprint Genetics.
• Select the Patient Payment option on the test requisition form and indicate payment method. Please include the patient’s contact information (phone and email). The patient will be contacted by our billing team to discuss the cost of testing and payment options, including financial assistance. If you wish to discuss alternative payment options, please contact our billing support team. Blueprint Genetics accepts a variety of payment methods including bank transfers, credit cards, or checks.

For questions about our patient payment options please contact our billing support team at 650.452.9340 Ext. 1 or billing.us@blueprintgenetics.com.

Medicare

For registered hospital inpatients and/or outpatients that have Medicare coverage, Blueprint Genetics will bill the hospital directly. For all other Medicare patients, a signed and completed Advance Beneficiary Notice (ABN) is required for molecular tests, as Medicare may not cover molecular testing.

Medicare Advantage

Blueprint will file claims with the patient’s health plan. The patient will be held liable for any balance due as indicated on the Explanation of Benefits (EOB). The patient may qualify for financial assistance.

Blueprint Genetics is not a participating provider in any Medicaid program.  Medicaid patients may qualify for financial assistance.

Uninsured or Self-Pay Patients, Blueprint Genetics offers a discount to patients who are uninsured or who wish to pay out-of-pocket. For specific details, please see our Financial Assistance Program page.

Blueprint Genetics has a generous Financial Assistance Program (FAP), including payment plan options, for patients and families who experience economic challenges associated with their clinical situation or family income level. Patients with any commercial insurance are eligible for this program, as are those covered by Medicaid, Medicare, and Tricare. Patients without insurance are also eligible.

More information on our Financial Assistance Program can be found here: https://blueprintgenetics.com/financial-assistance-program/