Billing Information for Tumor Profiling
The cost of healthcare, including molecular testing, can play a large role in the care of cancer patients. The information provided below is general in nature and addresses commonly asked billing questions. If you would like more information, contact us at 1.888.979.8669 or MIClientServices@carisls.com.
Reimbursement Coverage and Cost
Caris Molecular Intelligence® is typically reimbursed by insurance providers, as well as Medicare. Depending on the profile ordered, the number of markers analyzed and technologies used, the cost will differ among the various Caris Molecular Intelligence services.
Caris Life Sciences accepts most insurance plans, including Medicare. We will perform the services ordered and deemed medically necessary by the physician regardless of our network status.
Caris Life Sciences will file insurance claims for services provided on the patient’s behalf, including appeals for denied claims. Therefore, at the time the order is submitted, all necessary health insurance information is required for each patient.
Patients are financially responsible for any deductibles, co-payments, and/or co-insurance deemed the patient’s responsibility in accordance with federal and state regulations and the patient’s individual insurance plan.
For those patients that do not have health insurance or would like to pay directly for the services, payment plans and self-pay discounts are available. Caris Life Sciences has established a Compassionate Care program to assist uninsured patients or those who cannot afford associated out-of-pocket costs (limits and conditions apply).
Hospital Billing and 14 Day Rule Review (Date of Service)
Caris Life Sciences complies with regulations promulgated by the Centers for Medicare and Medicaid Services (CMS). The “14-day rule” is a regulation developed by CMS that requires all laboratories, including Caris Life Sciences, to bill the hospital for clinical laboratory services and the technical component of pathology services provided to Medicare patients ordered less than 14 days after the patients discharged from the hospital.
In certain instances, the hospital may be able to submit certain laboratories fees charged to their institution for in- and out-patient services. Please check with your local billing/administrative personnel for more information.