Our goal at Exosome Diagnostics, Inc. (Exosome) is to provide you information on the reimbursement process that will occur between you and your insurance company and provide you the best possible coverage for the EPI test ordered by your healthcare provider.
Our billing process is outlined below:
Exosome will file a claim to your insurance company for payment once the EPI test your physician ordered has been processed. The typical time for an insurance company to respond to a claim is approximately 45 days.
Review of Explanation of Benefits (EOB)
Once your plan has processed the claim for the EPI test, they will send you a statement called an Explanation of Benefits (EOB). The EOB is NOT A BILL, but is provided to you and to Exosome as a summary of how your insurance company processed the claim. An EOB also shows any cost sharing amounts (co-insurance, deductible, or patient balance) that are your responsibility.
If coverage is denied, Exosome will promptly appeal the claim on your behalf. After the appeal is reviewed, your insurance company will make a coverage or denial payment determination. You may receive multiple EOBs during this process, which is standard practice. As a reminder, the EOB is not a bill and does not require any action on your part.
Upon completion of claims processing with your insurance company, Exosome may send you a patient statement for any outstanding cost sharing amount; co-payments, co-insurance, or deductibles. Most patient statements will be sent upon 90 days from the date of service unless the claim has been appealed, in which case, those statements may not be sent for up to 6 months. This statement will be followed by a bill for any amounts owed to Exosome, which must be paid within 30 days.
If you have any billing or health insurance-related questions, please call our Billing Representatives at (888) 336 8283 (Ext. 242 or 245)
Monday to Friday 9:00 AM to 5:00 PM ET.
This test was evaluated and its performance characteristics determined by Exosome Diagnostics, Inc. It has not been cleared or approved by the U.S. Food and Drug Administration (FDA). The FDA has determined that such clearance or approval is not necessary. Exosome Diagnostics is certified under the Clinical Laboratory Improvement Amendments (CLIA) Act of 1988 as qualified to perform high complexity clinical testing. CLIA number – 22D2093470
Exosome Diagnostics and ExoDx, are registered and unregistered trademarks of Exosome Diagnostics, Inc.