We often use in-network labs, however, many of the laboratory tests used in Functional Medicine and Nutritional Counseling are provided by non-network labs or cash pay only labs.
Some of the labs will file with private PPO insurance companies directly. Typically, with these labs, there is a one-time upfront fee required from the patient at the time of submitting their sample and a known MAX bill rate. After the lab collects the upfront fee and files with insurance, the patient could receive an additional bill, not to exceed the known MAX bill rate. We recommend our patients pay this additional bill timely in order to not be charged additional once outside the allowable insurance billing window.
Insurance parameters are always changing, sometimes with out warning, and we strive to stay abreast these changes with as much detail as we can to help our patients understand how their insurance will work with labs.