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Pathway Genomics lets you order lab requests, check report status and receive email notifications through our online physician portal, Pathway Atrium™. Login to Pathway Atrium™ to submit a lab request.

We currently accept a variety of billing types for genetic testing services. Refer to the resources below for billing options, preauthorization forms, sample collection instructions and other frequently asked questions to submit the appropriate information with your lab request.

Billing Options

Consumer Insurance and Medicare

Pathway Genomics is nationally contracted with a number of health insurance plans. If you would like to select Pathway Genomics as your provider of laboratory services for your members through a contracting arrangement, please email us at:  managedcare@pathway.com.

Pathway Genomics will bill commercial insurance or Medicare on your behalf. To utilize this option, please selection option 3, “Bill Insurance,” in the test requisition form. To learn more about billing commercial insurance or Medicare options for your patients, including all of the required material, please contact Pathway Genomics billing department at (877) 559-1590 or billing@pathway.com.

Direct Institutional Provider Billing

Pathway Genomics is able to contract with individual medical practices, hospitals, and other medical institutions to provide genetic testing at a set cost for each patient. If institutional billing is desired, please select option 2, “Invoice Practice / Direct Institutional Bill / Facility Bill,” in the test requisition form.

Pathway Genomics accepts no liability for a provider’s compliance with all applicable federal and state laws that govern proper billing of patients or third party payers, such as anti-mark up, direct patient billing, discounts and disclosure requirements. Please consult with your healthcare law advisor.

Direct Patient Billing

Pathway Genomics offers affordable cash payment prices for all of its genetic tests. Patients always have the option of directly paying for their genetic testing without utilizing commercial insurance or an institutional billing account.

If direct patient billing is desired, please select option 1, “Credit Card” on the test requisition form. We accept Visa, MasterCard, American Express, and Discover as valid forms of credit card payment.

If you are interested in any of these billing options, please contact Pathway Genomics Billing Department or Client Services Department.

Financial Assistance Program

Pathway Genomics is committed to making our genetic testing affordable for all patients that will benefit from them. When Pathway Genomics files an insurance claim on your behalf and a balance is due, you will receive an invoice in the mail accompanied by information about how to qualify for our financial assistance program (FAP). Patients who qualify for our FAP may be eligible for discounts, financial assistance and/or alternative payment options. Patients not qualifying for the FAP are encouraged to call Pathway Genomics to discuss payment options.

Pathway Genomics will confirm eligibility of insured patients FOR CANCER TESTS ONLY and notify them by telephone if cost appears likely to exceed $250 after negotiations by insurer (Explanation of Benefits). Pathway will cover the cost if we fail to properly notify the patient; but the patient will have to pay if they do not return Pathway’s call or authorize us to go forward with the test.

To learn if you qualify for Pathway’s financial assistance program, contact our billing department at (877) 559-1590 or billing@pathway.com.

To apply, a patient must fill out the Financial Assistance Program Application form. Please note that the form requires documentation of income, a description of the financial hardship and other information required to determine eligibility for a hardship discount.

Patient Financial Policy

We will send a bill to your insurance carrier on your behalf and exhaust all efforts to collect your bill. However, your insurance policy is a contract between you and your insurance company. Patient responsibility is defined by your insurance carrier and Pathway Genomics is legally bound to follow to their determination.

We have payor contracts with many insurance companies and other health plans. These insurance carriers will pay us directly upon claim adjudication. If you are insured by a plan that we are not contracted with, we will still submit claims to your carrier on an out of network basis. However, this sometimes means the insurer will send the payment directly to you. Any funds received from the insurance carrier in these cases are to be remitted directly to Pathway Genomics immediately at PO Box 101580 Pasadena, CA 91189-1580.

Pathway bills are not included in your charges from your doctor’s office. They will be sent separately. You may receive a bill from us if you are a cash pay patient; your insurance carrier assigns a deductible, coinsurance, copay or other out of pocket amount; or your insurance carrier denies payment in full. Payment is due upon receipt of a statement. Failure to pay your bill may result in your account being referred to collections, at which point you may incur collections fees.

Pathway offers a need based financial assistance program to qualified patients.

Please call (877) 559-1590 or billing@pathway.com with questions about your bill. Our patient advocates are trained to assist patients with their billing and payment questions and are available Monday through Friday.

Forms for Pre-Auth

Please find the appropriate preauthorization form below based on your patient’s insurance company and note that preauthorization is not a guarantee of coverage.

Forms for Your Practice

Provider Interpretation Guides

ICD-10 and CPT Codes

ICD-10 and CPT Codes

ICD-10 is a set of codes used by medical providers to describe the medical diagnoses/ conditions of his or her patients. When it pertains to genetic testing, it is important for the medical provider to supply the diagnostic laboratory with the indication to allow for testing, in the form of an ICD-10 code. For example, if the provider is ordering comprehensive BRCA1 and BRCA2 analysis (BRCATrueTM) on their patient due to a diagnosis of early-onset breast cancer, an appropriate ICD-10 code to utilize might be 174.9. It is important to remember to always utilize ICD-10 codes that support the reason for genetic testing so that an insurance company can understand why the testing was ordered. To aid in selecting an appropriate ICD-10 code for testing, Pathway Genomics has provided some of the more commonly used ICD-10 codes on the back of the test requisition form. However, we understand that this list is not comprehensive, thus please be sure to provide an ICD-10 code that best describes your patient and the indication for testing.

If you are not sure what ICD-10 code is best to use for your patient, you can input your patient’s diagnosis here to receive the proper ICD-10 code.

Pathway accepts no liability for proper coding by professional providers for tests ordered for their patients. Please talk to your billing code specialist or third party payer for specific guidance.

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CPT codes are five digit numeric codes that are used to describe a medical, laboratory, etc. services provided by physicians, hospitals, laboratories, and other health care entities and are used for reimbursement purposes. These codes are used to reflect the actual service or procedure that is being performed, and are maintained and copyrighted by the American Medical Association. Pathway Genomics accepts no liability for proper coding by professional providers for tests ordered for their patients. Please talk to your billing code specialist or third party payer for specific guidance.

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Sample Collection Instructions

Billing and Insurance FAQ’s

Frequently asked questions

We realize you may have questions about your insurance and/or a billing-related matter. These frequently asked questions may help. If you need to reach someone in  billing, please contact us at 877-559-1590 (Mon-Fri 8am-5pm PST) or by emailing us at billing@pathway.com.

Requirement Checklist

Insurance: PathwayFit® or DNA Insight tests

My patient has insurance and is ordering a PathwayFit® or DNA Insight™ Pathway Genomics test:

What we require:

  • Completely filled out test requisition form
  • Physician and patient signatures
  • ICD-10 diagnosis codes (2 co-morbidities)
  • Copy of insurance card (front and back)
  • Pathway Genomics Consent Form for Non-Cancer Testing
  • 2 patient identifiers on the specimen vial
    • Without identifiers on the tube, the sample will be automatically cancelled
  • What we recommended including:
    • Relevant chart notes and/or letter of medical necessity to support ICD-9 codes

Insurance: Hereditary Cancer tests

My patient has insurance and is ordering a hereditary cancer specific test:

What we require:

  • Completely filled out test requisition form
  • Physician and patient signatures
  • ICD-10 diagnosis codes (2 co-morbidities)
  • Copy of insurance card (front and back)
  • Pathway Genomics’ Consent Form for Cancer Testing
  • Clinical History Questionnaire
  • Relevant chart notes and/or letter of medical necessity to support ICD-9 codes
  • 2 Patient Identifiers on the specimen vial
    • Without identifiers on the tube, the sample will be automatically cancelled

Cash: Any Pathway Genomics test

My patient will pay cash for any Pathway Genomics test.

What we require:

  • Completely filled out test requisition form
  • Physician and patient signatures
  • Invoice information
  • Pathway Genomics’ Consent Form for Non-Cancer Testing
  • 2 patient identifiers on the specimen vial
    • Without identifiers on the tube the sample will be automatically cancelled

Medicare: PathwayFit® or DNA Insight tests

My patient has Medicare insurance and is ordering a PathwayFit® or DNA Insight™ Pathway Genomics test.

What we require:

  • Completely filled out test requisition form
  • Physician and patient signatures
  • ICD-10 diagnosis codes (2 co-morbidities)
  • Copy of Medicare insurance card (front and back)
  • Pathway Genomics’ Consent Form for Non-Cancer Testing
  • 2 patient identifiers on the specimen vial
    • Without identifiers on the tube, the sample will be automatically cancelled
  • What we recommend including:
    • Relevant chart notes and/or letter of medical necessity to support ICD-9 codes

Medicare: Hereditary Cancer tests

My patient has Medicare insurance and is ordering a hereditary cancer specific test:

What we require:

  • Completely filled out test requisition form
  • Physician and patient signatures
  • ICD-10 diagnosis codes (2 co-morbidities)
  • Copy of insurance card (front and back)
  • Medicare ABN 
  • Pathway Genomics Consent Form for Cancer Testing
  • Clinical History Questionnaire
  • Relevant chart notes and/or letter of medical necessity to support ICD-9 codes
  • 2 patient identifiers on the specimen vial
    • Without identifiers on the tube the sample will be automatically cancelled

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Pathway Genomics Billing Department

Phone:  877-559-1590; Mon-Fri 8am-5pm PST

Fax:  858-866-9751

Email:  billing@pathway.com

Client Services

Pathway Genomics Client Services Department

Phone: 877-505-7374; Mon-Fri 8am-5pm PST

Fax: 858-866-8505

Email: clientservices@pathway.com