Billing Policy

Billing

Pacific Edge Diagnostics USA Ltd has established a billing policy based on federal, state, and the Office of the Inspector General (OIG) regulations. Pacific Edge is committed to every patient having access to the highest quality test for the rule out and surveillance of urothelial cancer and we will make every effort to make sure that Cxbladder is financially accessible.

Insurance

Pacific Edge will bill the patient’s insurance for Cxbladder. Patient’s financial responsibility will be determined by the patient’s health plan coverage of Cxbladder to include appropriate co-pay, deductible, and/or co-insurance.  As required by law, patients are responsible for all copays and deductibles as defined by their insurance company. Most patients are  eligible for the Cxbladder patient financial assistance program.

Medicare

Cxbladder is now covered by Medicare. 

Explanation of Benefits

A patient may receive an Explanation of Benefits (EOB) statement from their insurance provider. This is not a bill. Patients should review the EOB statement but should not pay the amount listed. Once a Cxbladder claim is processed through insurance, Pacific Edge will send a final billing statement to the patient. The Pacific Edge billing statement will detail all charges for the Cxbladder test; the amount(s) paid by insurance; any applicable co-pay/co-insurance and/or deductible; as well as the patient responsibility amount payable to Pacific Edge. Patients are encouraged to contact Pacific Edge’s billing department when the billing statement is received, as they may qualify for patient financial assistance. Patients may also receive a letter from their commercial carrier stating that our services may not be covered. This is also not a bill as the claims are still going through the normal appeals process. Pacific Edge works hard to collect from your insurance company, even if we get an initial denial of coverage.  We may require your authorization to allow us to appeal on your behalf.

Patient Financial Assistance

Pacific Edge is committed to ensuring that all patients have access to Cxbladder, regardless of financial circumstances. Programs for patients with financial needs are available. Patients should contact the Cxbladder Assist Team at 1-855-CXBLADR (1-855-292-5237, option 1) to determine eligibility. You can enroll in our patient financial assistance program at any time.

Uninsured Patient Assistant Program

Please call the Cxbladder Assist Team to determine eligibility for uninsured patient assistance: 1-855-CXBLADR (1-855-292-5237, option 1).

Contact Us

Our staff is available to assist with any questions related to insurance coverage, patient assistance programs, or general billing inquiries.

Pacific Edge Diagnostics USA Ltd - Billing Department

Phone: 1-855-CXBLADR (1-855-292-5237, option 3)
Fax:  (717) 220-7006
Email: [email protected]
Hours: Monday - Friday
8:30 am - 5:00 pm EST
7:30 am - 4:00 pm CST
5:30 am - 2:00 PM PST

Last Updated: 20 Mar 2024 01:38 pm