When the patient accepts the Price Transparency Offer, remember cases will show in Natera Care with a Workflow Status as CLOSED and Option Patient Chose would be PREPAY.
Quick Tips:
- Closed to Prepay cases WILL NOT load in AMD; therefore, everything should be resolved using LIMS and Natera Care.
- Payments for these cases will be reflected in Natera Care, you should look at the Amount Proposed for Payment that should match the Amount Paid, if the PT made the payment online there will be no notes, if the Pt paid with an agent there should be notes left by the agent who assisted with the payment.
- If the Pt asks for a copy of their receipt we can offer an Itemized bill
- These cases can be handled by Billing agents as usual and notes will be left in LIMS.
INSURANCE UPDATE FOR PREPAY CASES
When a case is already CLOSED TO PREPAY and the patient wants to add their insurance information, please consider whether the patient has already made their payment.
Payments should be found in the notes in Natera Care.
If there’s no payment, leave all relevant details for an insurance update in your LIMS notes and submit an “Insurance Update” ticket via Syncro CRM
We are not sure if the insurance will cover patients, so please make no guarantees. Provide TAT to determine eligibility within 5-7 Business days. The procedure with insurance takes the regular 30 to 45 business days to complete.
If there’s already a payment processed, please proceed to educate patients before you send an insurance update with the following details:
- The claim might be denied per PA missing
- The insurance may leave a Patient with a Responsibility that can be higher than the self-pay rate (based on deductibles, Co-insurance, and copays PT has with insurance).
If the PT understands that and still wants to continue, agents can capture all relevant details for an insurance update, submit an “Insurance Update” ticket via Syncro CRM and update the patient’s insurance information in LIMS.
In the scenario where the patient requests a refund, remember it cannot be initiated if the insurance company does not respond to the claim stating they will be covering the test.
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Last update by: Claudia F (July 3, 2024)