| The physician is reimbursed for
the interpretation of the test by billing against CPT
Code 91065 with a suffix of 26 (91065-26).
Metabolic Solutions is reimbursed for the test kit and
laboratory service by billing the patient’s health insurance
against CPT Code 91065.
Metabolic Solutions is a contracted provider for:
- Blue Cross / Blue Shield
- Medicare
- Tricare
- Humana / ChoiceCare
- MagnaCare
- ASMED Health Partnership
- Qualchoice
- UMWA Health and Retirement Funds
- Medicaid in all states but Florida, Massachusetts
and Kentucky.
Metabolic Solutions always accepts
the allowed charges and only bills patients when the
insurance company instructs us to collect deductibles
or co-insurance payments.
For subscribers to medical plans where Metabolic Solutions
is not enrolled as a provider, there is often coverage
through either an out-of-network benefit or by getting
a pre-authorization. Preauthorization is easy to obtain
because there is seldom an in-network option. Metabolic
Solutions accepts as payment in full the “reasonable
and customary” fees established by each insurance
company.
|
