Oncology and Organ Health

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ONCOLOGY & ORGAN HEALTH TRANSFERS

Spectrum: Warm transfer calls to SPECTRUM 650.412.7251
Signatera, Altera, Prospera, Renasight : Warm transfer calls to Signatera 8555796657
Empower test ordered by an OBGYN or women’s clinic, oncologist or oncology clinic billing agents can handle the call.
ONCOLOGY & ORGAN HEALTH SCRIPTS

Oncology Tests

  1. Signatera
  2. Altera
  3. Empower (ovarian, uterine, colorectal, prostate, pancreatic, melanoma, gastric)
Oncology Coverage by Insurance:            

Medicare(Traditional)    For Signatera, Altera, and Empower Covered- the patient is not expected to have an out-of-pocket.

Medicaid (Traditional) For Signatera, Altera, and Empower Covered- the patient is not expected to have an out-of-pocket.

Commercial Plan For Signatera, Altera, and Empower we will bill the patient for co-pay / deductible/coinsurance per the EOB and insurance plan.

-Commercial Plan ended up on NCS

  • For Signatera patient will not have an out of pocket
  • For Altera testing will not be run for stages 1 or 2, unless an exception.
  • For Empower we offer the patient $249 prompt-pay rate via PTP.

-Tricare(military health benefit)

  • Signatera, Altera, and Empower will be covered but we will bill the patient for deductible/coinsurance/ co-pay based on the plan.

ONCOLOGY WALK DOWN

Organ health Tests

  1. Prospera
  2. Renasight

If a parent or legal guardian calls on behalf of a minor patient, the HIPAA process should align with the caller type Patient.We should include the parent or legal guardian’s info in the Memo

Organ health Coverage by Insurance:            

Medicare

  • For Prospera and Renasight Covered- the patient is not expected to have an out-of-pocket.

Medicare Advantage

  • Prospera is covered but may have out-of-pocket based on the insurance plan.
  • Renasight is Not covered, the patient may have co-pay /deductible/coinsurance per the EOB.

Medicaid

  • Prospera is Not covered.
  • Renasight will need to follow EOB.

-Commercial Plan

  • Prospera and Renasight will need to follow the EOB.

-Tricare(military health benefit)

  • Prospera and Renasight are covered but will have deductible/coinsurance/co-pay based on the plan.
ORGAN HEALTH WALK DOWN

Last update by: Nina O (Dec 18, 2024)

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