Billing information

OneOme’s mission is to provide the most cost-effective, pharmacogenomic testing and tools for providers across the globe to use in everyday patient care. In order to achieve this goal, we offer multiple billing options.


RightMed test billing options

At OneOme, our goal is to provide every patient with access to a RightMed test. That’s why we’ve created a billing process that supports multiple payment options including:

Our client services team is available to work with you to find the best billing option for your scenario. CONTACT US for more information or review our billing FAQs.


Patient self-pay

Patients may pay $249 for the RightMed test directly at the time their provider submits the order, or OneOme can contact the patient to collect payment after the provider submits the order. OneOme accepts payments from all major credit cards, HSA accounts, and PayPal. In addition, we offer interest-free payment plans when needed. Please CONTACT US for more information about interest-free payment plans.

Please note that the sample will not be processed until payment is collected or a payment plan has been established.


Institutional billing

We can bill institutions directly at our current list price without a contract. Discounted pricing is available with a contract. Testing is not invoiced until a report has been delivered. We offer a variety of payment options including check, credit card, or wire transfer. Please CONTACT US for more information.


Insurance billing

OneOme will work with a patient’s insurance company to determine coverage and payment regardless of the patient’s in-network or out-of-network status. Our goal is for patients to access the lowest estimated payment option available. We review the patient’s insurance information and assess their payment options using the patient’s deductible, co-insurance, and health plan details. If the patient’s out-of-pocket cost is estimated to be less than or equal to OneOme's self-pay price of $249, OneOme will submit the claim to the insurance plan. If the patient’s out-of-pocket cost exceeds OneOme’s self-pay price, OneOme will reach out to the patient.

If a patient has a balance, they can pay by check, credit card, or HSA, and will also have the option to establish an interest free payment plan. OneOme’s client services team will ensure that the patient understands the process and that they are effectively communicated with along the way.


Process

  • OneOme reviews the patient’s insurance information to make sure it is complete and accurate.
  • OneOme will confirm insurance requirements and determine the estimated out-of-pocket costs for the patient.
  • OneOme will contact the patient if the patient’s estimated out-of-pocket cost exceeds the self-pay price to offer them alternative payment options.
  • OneOme sends an informational letter to the patient describing the process and what to expect.
  • OneOme submits the insurance claim directly to patient’s insurance company, once the order is processed.
  • Patient receives an explanation of benefits (EOB) from their insurance company in the mail.
    • This is not a bill.
    • OneOme will handle any appeals processes.
  • Patient receives an invoice from OneOme for any deductibles, co-insurance, co-payments as defined in their insurance policy’s Explanation of Benefits (EOB), and for services deemed non-covered or ineligible under their insurance policy.


Private insurance
OneOme is actively working towards increasing our coverage and accessibility by gaining in-network status for our testing.


Medicare and Medicaid
OneOme currently does not bill Medicare or Medicaid, however we offer a patient self-pay option and interest free payment plans.


Billing codes
It is the responsibility of the submitting party to determine the correct billing codes to use when filing billing claims to third-party insurance. Below is a list of relevant codes.


GENE

CPT code

CPT code description

CYP1A2

81479

Unlisted molecular pathology procedure

CYP2B6

81479

Unlisted molecular pathology procedure

CYP2C19

81225

Cyp2c19 gene com variants

CYP2C9

81227

Cyp2c9 gene com variants

CYP2D6

81226

Cyp2d6 gene com variants

CYP3A4

81401

Mopath procedure level 2

CYP3A5

81401

Mopath procedure level 2

SLCO1B1

81400

Mopath procedure level 1

UGT1A1

81350

Ugt1a1 gene

VKORC1

81355

Vkorc1 gene

F2

81240

F2 gene

NUDT15

81479

Unlisted molecular pathology procedure

F5

81241

F5 gene

OPRM1

81479

Unlisted molecular pathology procedure

COMT

81479

Unlisted molecular pathology procedure

DRD2

81479

Unlisted molecular pathology procedure

HTR2C

81479

Unlisted molecular pathology procedure

HTR2A

81479

Unlisted molecular pathology procedure

DPYD

81400

Mopath procedure level 1

GRIK4

81479

Mopath procedure level 2

IL28B

81400

Mopath procedure level 1

TPMT

81401

Mopath procedure level 2

SLC6A4

81479

Unlisted molecular pathology procedure


The RightMed pharmacogenomic test was developed and its performance characteristics have been determined by OneOme, LLC, a clinical laboratory located at 807 Broadway Street NE, Suite 100 Minneapolis, MN 55413. It has not been cleared or approved by the U.S. Food and Drug Administration. OneOme is regulated under CLIA-88 as qualified to perform high-complexity testing. This test is used for clinical purposes and should not be regarded as investigational or for research.





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