Redraw Billing Policy & Scripts

A redraw occurs when the first test cannot be performed. Sometimes, the test fails to provide a result, usually because of low cell-free DNA fetal fractions.

When is a Redraw requested?

Natera will automatically contact a patient to schedule a redraw if the patient’s requisition form indicates they want to be included in the automatic redraw program.

When a Redraw is successful?

A redraw can be successful when women who don’t received a result on their first test have a good chance of getting a result on a redraw. 

Factors that may contribute to a successful redraw include:

• The interval between blood draws
• The maternal weight
• Fetal fraction measured at the first draw.

Patient Communication Guidelines

1. Redraw Payment:
   • • The patient paid for the first draw and received a statement for the redraw. Explain that they are only responsible for the first test, and the redraw has a $0 patient responsibility. Confirm the payment in the system and advise them to disregard the second statement, as payment has already been collected. Submit a Zbal request in Synco CRM for the second case.
2. No Results Inquiry:
   • If the patient questions why insurance was billed for a redraw with no results, clarify that billing occurs because the lab performed the screenings despite the lack of results. Direct them to follow up with their doctor for further explanation.
3. Overpayment and Refund:
   • Since the patient paid for both the first and redraw cases, they may be due a refund for any overpayment. Confirm all payments and check for any other applicable cases. If overpayment is confirmed, submit a refund request via Syncro CRM. Refunds may take up to 60 business days depending on the payment method.
4. Microdeletions Charge:
   • For patients who ordered a Panorama on the first draw and added Microdeletions on the redraw, inform them that they will owe more to cover the cost of microdeletions.
5. High Risk – Fetal Fraction:
   • High-risk results due to Fetal fraction are billable

Policy Summary

• Billing Practices:
  • For most tests, we bill upon the delivery of the redraw result, not the first test.
  • For Panorama, we bill based on result types; some may contain actionable information even if a redraw is recommended.
• Panel Increases:
  • If a redraw includes a higher panel than the first draw, the patient will owe in both cases. Inform them, “The second test order included additional panels, so your overall responsibility will be adjusted accordingly.”
• Multiple draws with “No Result”:
  • Insufficient Fetal DNA or Borderline LFF
  • Declining Third draw
    • We will bill one time only
• Second Result – Clinically Relevant
  • Example: low fetal fraction being indicative of an issue
    • We will bill one time only

Identifying Redraws in LIMS and AMD

1. This can be found in ‘Redraw Case(s)  
2. ‘Same Patient Case(s)
3. Search by Patient’s full name and Date of Birth

AMD

1. Search by case ID using ~xxxxxxx, then take the ‘Chart Number’ to search for ALL cases linked to the patient.

Last update by:  Nina O (March 7,2025)