A limited number of specialized (esoteric) tests ordered through IHD Labs require processing by ARUP, a third-party reference laboratory. Because these tests are referenced to a ARUP, and ARUP does not bill insurance, they may be subject to different billing and insurance rules than tests performed directly by IHD Labs.

 

Insurance Coverage:

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Insurance coverage for reference laboratory testing varies by plan. Certain payors—including most Blue Shield plans—do not permit pass-through or reference laboratory billing.

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As a result:

• Insurance reimbursement cannot be sought from IHD for the reference laboratory testing. 

• When a reference laboratory does not accept insurance, such as ARUP, in cases pass through billing is not permitted by the payor the patient is financially responsible for the testing charges.

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Patient Responsibility:

 

When it is determined that reference laboratory testing requires direct payment, an IHD Labs representative will contact the patient to collect the applicable fees and collect payment to process. Upon request, IHD Labs can provide a HCFA (CMS-1500) form and a cover sheet, so the patient may seek reimbursement directly from their insurance carrier, if applicable. IHD Labs is not responsible for coverage determinations or reimbursement decisions made by insurance plans.

 

Our Commitment:

 

IHD Labs is committed to transparency and will make reasonable efforts to:

• Identify tests that require reference laboratory processing

• Provide pricing information upon request

• Answer questions related to billing and insurance coverage

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