Carrying the financial burden of cancer care can be stressful. As part of your care team, Caris Life Sciences® is dedicated to ensuring that every cancer patient has access to the best possible treatment. While most insurance plans cover Caris molecular testing, we have additional financial assistance programs for patients that provide added financial flexibility.
Caris molecular profiling is typically reimbursed by insurance providers, as well as Medicare. The cost will differ among the various Caris molecular profiling offerings, depending on the tumor profile offered, and the number of biomarkers analyzed and technologies used. We will perform the services ordered and deemed medically necessary by a physician, regardless of our network status.
At the time of order, all necessary health insurance information is required for every patient. Caris will file insurance claims for services provided on the patient’s behalf.
If coverage is denied, Caris billing specialists will work with the insurance provider to file appeals and pursue coverage on your behalf.
Caris will bill your insurance company directly as an independent service provider and work with them to process claims. Depending on the terms of your healthcare plan, you may receive a bill for the deductible, co-insurance, or co-payment after your insurance company has processed the claim.
Our Patient Navigators are dedicated to educating patients and families affected by cancer about their options with Caris molecular profiling. Once testing is ordered, a Patient Navigator is assigned to work directly with the patient through all aspects of molecular profiling, including explaining how the testing works, reviewing Explanation of Benefits (EOB) statements, and discussing financial options. If you are a patient and have questions about Caris or Caris molecular profiling, please contact us or call 1.888.979.8669.
While Caris molecular testing is covered by most insurance plans, we have additional financial assistance programs that provide added financial flexibility for patients. Caris’ Compassionate Care Program assists uninsured patients who may not be able to afford out-of-pocket costs associated with our molecular profiling test.
For patients with traditional Medicare insurance, an Advance Beneficiary Notice of Non-coverage (ABN) may be required if the patient does not meet CMS coverage requirements for Caris testing. The ABN is intended to help Medicare beneficiaries make informed decisions about services Medicare may not cover in specific situations. Should a patient not meet the current CMS criteria for coverage, Caris will contact the patient and treating physician to obtain an ABN.
Caris will bill your insurance company directly as an independent service provider and work directly with them to process claims. Insurance companies usually take 60-90 days to respond to claims from Caris. You may receive an Explanation of Benefit (EOB) during this time, but an EOB is NOT a bill. According to the terms of your healthcare bill, a bill for the deductible, co-insurance or co-payment may be sent after the insurance company has processed the claim.
The EOB is NOT a bill. The EOB is an estimate of financial responsibility for the insurance company and the patient. Each time Caris submits a claim to an insurance provider and the claim is processed, the insurer sends an EOB that details what portion of the claim the insurer will pay. An EOB may not require payment even if there is an “Amount Due” indicated. If you have any questions about an EOB, please contact your Patient Navigator at 1.888.979.8669.
Caris billing specialists will work with the insurance provider to file appeals and pursue coverage on your behalf.
If you receive a reimbursement check directly from your insurance provider, please forward the payment directly to Caris for the services we performed. Caris will contact and invoice patients who receive direct reimbursement payments from their providers.
Your Patient Navigator is available to answer any questions you might have, at 1.888.979.8669. Please have your account number (found on your bill) and insurance policy number (located on your insurance card) available for all billing inquiries.
Deconstruct your cancer’s molecular composition.