| →Last Update 04/13/2023————————————>>>>> | ALL CHAT CONVERSATIONS MUST BE COPIED AND PASTED INTO AMD. IF NO CASE IN AMD THEN PASTE IN LIMS.——————-ALL CHAT CONVERSATIONS MUST BE COPIED AND PASTED INTO AMD. IF NO CASE IN AMD THEN PASTE IN LIMS. |
| ►Chat | Agent Script |
| Long wait time | We appreciate your patience for holding and apologize about the wait time. |
| – | Thank you for contacting Natera, my name is [agent]. May I please have your case number? |
| Case # in IVR | Thank you for contacting Natera, my name is [agent]. Are you the patient for case number [xxxxxxx]? |
| No Case # | No problem, I can search for it. What is your name and DOB? |
| … | |
| Are you the patient? | |
| Yes, patient… | |
| For verification purposes, what is your address and phone number? | |
| … | |
| Thank you. How can I help you today? | |
| Gives case # | Thank you, Are you the patient? |
| Yes, is patient | For verification purposes, may I have your complete name and date of birth? |
| … | |
| What is your address and phone number? | |
| … | |
| Thank you. How can I help you today? | |
| Not patient | I’m sorry, due to HIPAA privacy laws, I am limited in how I can help without the patient’s authorization to share information with you. Please have the patient call our billing department at 844-384-2996 to have you authorized as a contact on this case. |
| No PT Auth on File | I’m sorry, without the patient’s authorization, I can only direct you to Natera.com for more information about our company. Please ask the patient to call us to give you authorization to discuss detailed information about this case. |
| Auth on file | For verification purposes, what is the patient’s name and date of birth? |
| … | |
| What is the patient’s address and phone number? | |
| … | |
| Thank you, and finally, please confirm your name and relationship to the patient. | |
| … | |
| How can I help you today? | |
| ► Closing & Chat Flow | |
| Hold | Please grant me a few minutes to review this case. Thank you! |
| Dead Air (After 2 minutes of no response) Followed by (1 minute) | Hello, are you still there? |
| I am sorry, due to no response I am disconnecting this chat. Thank you for contacting Natera. | |
| Different Department | Unfortunately, I cannot assist you further, this case is with our Price Transparency Program Department. You would have to call them directly at 844-384-2996 followed by Option #6 to discuss this case. |
| Closing | Is there anything else I can help you with, [patient’s name]? |
| … | |
| Thank you for contacting Natera and have a great day! | |
| ► Quoted Amount | |
| I thought it would cost $xx. | My apologies, I understand you thought the test would cost [$xx]. Do you happen to remember who told you that amount? |
| … | |
| An adjustment has been notated on this case. You will have to speak to a billing representive at 844-384-2996 to process payment due to this manual adjustment. | |
| Quoted less than $99 | I understand you thought the test would cost [$xx]. The typical amount for this test is [$249/349], so I have to get manager approval for this amount. We usually receive this in 1 to 3 business days. You may contact us via chat or call the billing center at 844-384-2996 for an update on this case. |
| Wants statement matching quote | I’m sorry, I’m not able to adjust your statement, what I can do is add a note to your account for the next agent to review when you call with the adjusted amount. Then, your case will be adjusted after you make the payment. |
| Can I pay the discount price online? | Unfortunately, no, I’m not able to adjust the payment portal. You would have to process your payment over the phone with a live agent. I will add a note to your account for the next agent to see when you call. What would work for you? |
| ► Self-Pay | |
| Why did I receive a bill? | Our records show you selected to self-pay for this test. |
| Did you bill my insurance? | No, we do not bill insurance for self-pay cases. |
| Why selfpay, my dr. sent you my insu. info? | Sometimes the insurance information is unreadable or incomplete, and our system defaults to send you a Self-Pay statement. |
| Can you bill my insurance? | Yes! Of course, we can submit the claim to your insurance. Depending on how your insurance covers the claim, you may receive an updated statement in 30 to 45 days. |
| ► Expired Prompt Pay Discount | |
| Why did my bill go up? | That was a prompt pay discount available if bills are paid within 30 days of the first statement. Since you have not made a payment, this discount is no longer available. |
| Pay old amt? | Sure, you will have to speak to live billing representative to process payment as this is a manual adjustment. I have notated the case to honor the adjusted amount. |
| ► NCS Prompt | |
| Why do I owe? | This is for your Panorama screening ordered by your doctor. |
| Did you already bill my insurance? | Not in this case, because based on our experience with your health plan, we know this service is NOT covered. So, to ensure testing is affordable, we applied our discounted self-pay rate of $249 or $349 to your [Panorama/Vistara] test. |
| Can you bill my insurance? | Yes! Of course, we can submit the claim, and please be aware you could owe more if your insurance covers the test, but most patients end up owing the same amount after insurance. |
| Why didn’t my insurance cover it? | Some insurances have a formal negative policy for non-invasive prenatal tests for average risk patients. Therefore, any time we submit a claim to these payors it is denied, and we know your insurance to be one of these. |
| How do I know my insurance coverage policy? | Those policies can vary plan to plan and may be available on your insurer’s website or from the primary insured’s employer. |
| How much will I owe if I don’t pay today? | Your amount due will go up to [$349,449,549, etc], when the prompt pay discount expires on [Month Day]. |
| ► NCS | |
| Did you bill my insurance? | Yes, we billed your insurance, and they denied the service. To make testing affordable, we applied a non-covered services discount to [$249/349]. |
| Statement went up | The first statement was a prompt pay discount, which expired after 30 days from the date it was sent. |
| Why did I receive a bill? | It looks like your insurance company denied the services. You are eligible for a prompt pay discount down to [$249/349]. |
| What is the discount? | The discount reflected on the bill is a provider discount we are offering since testing was not covered. |
| Can’t afford balance | I understand, we offer interest free payment plans. Is this something you can do? |
| Can’t afford payment plan | I understand your situation, one last option I can offer you is our Compassionate Care program. I can pre-screen you if this is something you’re interested in? |
| ► Medicaid | |
| I have Medicaid. | Thank you for notifying us. I need to add your Medicaid insurance to our system so we can submit the claim, and then you should not receive a statement from us. |
| Received NCS stmt | I apologize for the inconvenience. Since you had Medicaid at the time of your test, you will not owe anything. I will have your balance zeroed out. |
| ► Case is Paid | |
| I paid my case, but received another bill (2 Cases) | My apologies, after further review you processed a payment on [INSERT DATE] for your [Panorama/Horizon/Etc] in the amount of {INSERT AMOUNT]. The invoice you recently received was for your [Panorama/Horizon/Etc]. |
| I paid my case, but received another bill (1 Case Zero Balance) | My apologies, after further review you processed a payment on [INSERT DATE] for your [Panorama/Horizon/Etc] in the amount of {INSERT AMOUNT]. Seems the statement generated while your payment was in the process of posting to your case. |
| I paid my case(s), but received another bill (Zbal Required) | My apologies, after further review you processed a payment on [INSERT DATE] for your [Panorama/Horizon/Etc] in the amount of {INSERT AMOUNT]. I will have the remaining balance zeroed out on this case. It will take 3-5 business days to reflect on payment.natera.com. |
| ► INN, Covered | |
| Just got test, how much? | We won’t know the exact amount until your insurance finishes processing the claim, because your cost will depend on your specific insurance plan. If you get a statement that’s more than expected, please reach out to us and we will work with you. |
| I got a bill for 3,000, 5000, 8000, Etc. | I apologize, that seems high for a bill, let me take a look at your account… It looks like you received the explanation of benefits from your insurance company, which is not a bill. Your Natera bill will be arriving soon and then you contact us back with questions or pay online at payment.natera.com |
| Why do I owe? | Based on the explanation from your insurance company, you owe [INSERT AMOUNT]. This is based on your specific plan, and the amount remaining on your deductible and co-insurance. |
| Will you be using a Visa, Mastercard, Amex, or Discover card today? | |
| Can’t afford balance | I understand, we offer interest free payment plans. Can I set this up for you? |
| Can’t afford payment plans | Ok, I am able to offer you a 20% discount on your bill if you pay today. This discount brings your balance down to [calculate balance with 20% discount]. I will notate your case, however, you will be required to speak to live billing representative at 844-384-2996 to process payment. |
| Can’t afford 20% discount | I understand your situation, one last option I can offer you is our Compassionate Care program. I can pre-screen you if this is something you’re interested in? |
| ► OON, Covered | |
| Just got test, how much? | |
| At this time, your claim is still pending with your insurance, and we won’t know the exact amount you owe until they finish processing the claim. We are out of network with your insurance, so you might see a high total price on the explanation from your insurance, but please don’t be concerned because you may qualify for our prompt pay discount. Most out of network patients only owe 749 or less. If you get a statement that’s more than expected, please reach out to us and we will work with you. | |
| I got a bill for 3,000, 5000, 8000, Etc. | That seems high for a bill, let me take a look at your account. It looks like you received the explanation of benefits from your insurance company, which is not a bill. Your Natera bill will be arriving soon and then you can reach out to us if you have any questions or pay online at payment.natera.com |
| Why do I owe? | Based on the explanation from your insurance company, you owed more than $749, and to make testing more affordable, we applied a discount since we are out of network with your insurance. |
| Can’t afford balance | I completely understand, we offer interest free payment plans simply by calling our billing call center at 844-384-2996. |
| Can’t afford payment plans | Ok, I can actually extend our prompt pay discount to you, which brings your balance down to [$249/$349]. If you agree, you will have to speak to a live agent at 844-384-2996 as this is a manual adjustment. I will notate the discount on your case for you. Will this work? |
| Can’t afford prompt pay | I understand your situation, one last option I can offer you is our Compassionate Care program. I can pre-screen if this is something you’re interested in? |
| ► Case in Appeals | |
| How much do I owe? | Your case is currently in appeals, and we won’t know the exact amount you owe until they finish processing the claim. |
| Did you appeal? | Yes, we appealed on [date of appeal]. It can 30 to 60 days to receive a response, so we need to allow more time for processing. |
| Appealed and account shows balance due | Your patient responsibility is [$xxx] for the [non-covered services rate/deductible/coinsurance/Etc.] We also appealed the case, so you may receive another EOB in the future, and simply reach out to us if your patient responsibility changes. |
| Owes for case, and 2nd case in appeals (no balance due for 2nd case) | You owe “xxx” for the [Panorama/Horizon/Etc] test, and your [Panorama/Horizon/Etc] is still processing with insurance, so you may receive another statement in the future for that case. |
| ► UHC Level 2 Appeals ONLY | |
| Memo/Pop-up in Case “UHC 2nd level appeal. Agent use 2nd Level Appeal Script.“ | A member of our Appeals team can assist you, please email them at [email protected] to discuss your case. You can also call them at 650-489-9050, if you prefer. |
| ► General Insurance | |
| Why did you bill my insurance so much ($5,000, $8,000)? | That is the full list price that we bill to insurance. We do not expect to collect that amount from you or your insurance, because we have a contracted rate with them. |
| What is the contracted rate? | That is the amount insurance agrees to reimburse Natera for our services according to our contract, and every insurance plan may differ. |
| ► Updating Insurance in AMD | |
| I can add that to your case. What is the name of the insurance? | |
| … | |
| Is it a Medicaid? | |
| … | |
| On the back of the card, is there a PO Box? | |
| … | |
| What is your subscriber ID? | |
| … | |
| Is there a group number? | |
| … | |
| What is the effective date? | |
| …. | |
| Are you the primary insured? | |
| …No | |
| What is the name of the person who is primary? How is the primary insured related to you? | |
| … | |
| Is this your only insurance? | |
| No PO Box | No problem, I can search by name |
| Doesn’t have card | Ok, please reach out to us when you have that information so we can update your account. |
| ► Compassionate Care | |
| Pre-screen | I will ask you two questions to pre-screen you. How many people are in your household?” What is your annual household income?” |
| Does not qualify | Unfortunately, based on the information you provided me, you do not qualify for this program. I can still offer you a payment plan of… [or] your balance is … |
| Pre-screened | Based on the information you provided, you may qualify for our Compassionate Care program. Please provide your email address, and I will email you the application. |
| … | |
| Fill out the application and send it back with a copy of your W-2s for all adults in the household following the instructions on the form.” | |
| After we receive and process your application, you should receive a response in 3 to 5 business days. One of our reps will contact you via email or phone call to let you know if you qualify. I have noted your account. Is there anything else I can help you with?” | |
| Has approval code from online | Thank you for confirming your application. To complete it, you need to email your financial documents for review. It can be a copy of your W-2s for all adults in the household or recent pay stubs. Email them to [email protected]. You should hear back withing 3 to 5 business days with the status of your application. |
| ► OA-100 | |
| Received a check from ins. | Some insurance companies issue payment to the subscriber so you can pay us for the service. I can provide you instructions on how to submit that payment to Natera. Do you have the check in front of you? |
| Has check | Sign the back of the check, and underneath your signature, write: “Payable to Natera, Inc.” and your case #. Also, attach all pages of the Explanation of benefits that was included with the check, and then mail it along with the signed check, to, PO Box 399023, San Francisco, CA 94139 |
| Cashed check | Since you cashed the check, you need to pay Natera the same amount you received from your insurance along with the patient responsibility portion. |
| Insists did not receive a check | Since your insurance didn’t send you the check, we need to figure out where they sent the it. Can you call them and ask them to call us or fax us the information? You will continue to receive statements until this is resolved, so I recommend calling them soon. |
| Can you call my insurance? | Unfortunately, I am not able to do that. Since we are out of network with your insurance they will not share that information with us. |
| ► Payment | |
| Asks for the account balance and the reason for the charge. | Your account balance is $0x.xx due to a Deductible/Co-Insurance/Co-Payment Charge. You can make your payment by going to our portal payment.natera.com or by calling us at 844-384-2996. |
| Wants to pay | To process your the payment, you would have to call in and speak with a billing representative at 844-384-2996 or visit payment.natera.com |
| Can I do a payment plan? | Yes, can you pay half today and half next month? |
| … | |
| How much can you afford to pay each month? | |
| — | |
| I will notate you case, however, to process your the payment, you need to call and speak with a billing representative. Their number is 844-384-2996. | |
| Missing Payment | I do not show a payment in our system. How did you pay? When did you make that payment? Has it cleared your bank? What is the check number, or, what are the last 4 digits of the credit card? I will need some more time to research this, and then someone will call you back in 3 to 5 business days. What is a good call-back number? |
| Case not Zbal’ed | I apologize for the inconvenience. You do not owe anything for case. I will have the balance removed and please disregard the statement. |
| Zbal proof in writing | In 3 to 5 days you can login to payment.natera.com to verify your case is at a zero balance. |
| ► Balance Transferred to Collections Agency | |
| Wants to make payment | My apologies, your balance has been sent to collections. I am unable to process your payment here. You need to contact CCS at 781-620-8000 to take make your payment. |
| Received collection letter from CCS | That letter informed you that your balance has been sent to collections. You can contact CCS at 781-620-8000 to discuss your account. |
| What is CCS? | CCS is an outside collection agency that Natera placed your account with for recovery. |
| Why did you send my account to collections? | Typically, a case will qualify for collections due to non-payment. I strongly recommend you contact CCS at 781-620-8000 to discuss your account. |
| Will this affect my credit? | I strongly recommend you contact CCS at 781-620-8000 to discuss your account as they can provide that information. |
| ► Insurance Call | |
| Identifies self as an insurance representative | What is the patient’s name and Date of birth? |
| … | |
| I apologize, due to company policy and the protection of the patient we ask that all insurance providers call 844-384-2996 to speak to a live representative. Thank you for understanding. | |
| ► Payment Portal Issue | |
| Cannot access portal | My apologies. To process your payment at this time, you would have to call in and speak with a billing representative at 844-384-2996. Thank you for notifying us, and we will address this matter with our portal support team. |
| Payment not going through | My apologies. To process your payment at this time, you would have to call in and speak with a billing representative at 844-384-2996. Thank you for notifying us, and we will address this matter with our portal support team. |
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