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 different payment options, depending on how the test is ordered, 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

For RightMed tests ordered by a patient’s provider, patients may pay for the test directly at the time the 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.

For RightMed tests requested through the independent provider network, OneOme accepts payment from credit cards, HSA accounts, and PayPal (insurance billing is not available for this option).

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 accepts all insurance plans.

Private insurance
For RightMed tests ordered by a patient’s provider, OneOme will work with a patient’s private insurance company to determine coverage and payment. Our goal is for patients to access the lowest cost available. If the patient’s out-of-pocket cost is likely to exceed $249, OneOme will reach out to the patient to offer alternative options.

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.

OneOme Financial Assistance Program (FAP)
OneOme offers financial assistance to reduce out-of-pocket costs for qualified patients in the U.S. to no more than $249. To be eligible, patients must have private insurance, and meet low income requirements (household incomes up to 400 percent of the Federal poverty guidelines).

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. The EOB is NOT a bill, but an explanation of what was covered.
  • If coverage is denied or only part of the test is covered, OneOme will appeal the decision on behalf of the patient.
  • After a final coverage decision from insurance, a patient may receive an invoice from OneOme for any deductibles, co-insurance, co-payments, and for services deemed non-covered or ineligible under their insurance policy.

Medicare and Medicaid
OneOme accepts all Medicare and Medicaid plans. For traditional Medicare/Medicaid or Managed Medicaid Plans a patient’s out-of-pocket cost will be $0. Medicare Advantage Plans may have a co-payment or deductible requirement.

For traditional Medicare claims, we require a signed letter of medical necessity.

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 common variants

CYP2C9

81227

Cyp2c9 gene common variants

CYP2D6

81226

Cyp2d6 gene common variants

CYP3A4

81230

Cyp3a4 gene common variants

CYP3A5

81231

Cyp3a5 gene common variants

SLCO1B1

81328

Slco1b1 gene common variants

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

81232

Dpyd gene common variants

GRIK4

81479

Mopath procedure level 2

IL28B (IFNL4)

81283

Ifnl4 gene

TPMT

81335

Tpmt gene common variants

SLC6A4

81479

Unlisted molecular pathology procedure

The RightMed comprehensive 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.





Have questions?