We file your claim. →
Exosome Diagnostics will file a claim with your insurance company once The EPI Test is processed. Insurance typcially responds in less than two months with a coverage decision.*
We manage the process →
Exosome Diagnostics will work on your behalf to ensure you get the best coverage benefit. When applicable, Exosome Diagnostics will appeal the denial with your insurance. The insurance company will review the appeal to make a coverage or denial determination.
During this time, you may receive several Explanation of Benefits (EOB) statements. **
This is not a bill
You receive a statement
After the claims process is complete, or when the appeals process has reached a decision***, you will receive a statement for any outstanding cost-sharing amounts (for example, co-payment, co-insurance, deductibles) that remain your responsibility.
* If the claim is processed by insurance, most patient statements will be sent within 60 days from the date of service. If the claim has undergone the appeal process, it may take 6 months or longer to receive a patient statement outlining the patient responsibility. This statement will be followed by a bill for any amounts owed to Exosome Diagnostics, which must be paid within 30 days.
** An EOB is provided to you as a summary of your medical expenses and how claims were processed by your insurance company. An EOB will outline any cost-sharing amounts (co-insurance, deductible, or patient balance) that are the patient’s responsibility. THIS IS NOT A BILL.
*** Even after a coverage decision has been made by a patient’s insurance company, the patient may be eligible to pay a reduced cost if they qualify for our Patient Assistance Program (PAP). For more information on the PAP, please see reverse side.
The EPI Test is cutting-edge technology
This test will help you gain greater confidence and peace of mind to make a decision with your urologist or other healthcare providers about whether to proceed with a biopsy or not.
Patient Assistance Program
The cost of the test may be reduced for patients who qualify for our Patient Assistance Program (PAP), which evaluates eligibility for discounted out-of-pocket rates based on household income levels.
The PAP is only available to patients in the United States and US territories. To qualify, patients must complete and submit a PAP application form with proof of household income directly to our billing department.
Frequently Asked Questions
Is the EPI Test covered by health insurance?
Most claims are covered by insurance companies and we continue to add coverage from additional insurance plans. However,only your insurance company can determine if the cost of the test is a covered benefit. The code to use is CPT PLA 0005U.
If I have health insurance, will I have any out-of-pocket expense?
Given the differences among health insurance programs that determine covered services, co-insurance, co-pay and deductibles, it is difficult for Exosome Diagnostics to determine what any one individual’s out-of-pocket cost for the test might be at any given time in the year.
If I have gone through the appeals process, but am still unable to pay, what are my options?
Please review the information on our Patient Assistance Program (PAP) to determine whether you qualify for a reduced out-of-pocket cost for The EPI Test. In addition, several payment plan options are available. Please contact our billing department at 844-EXOSOME (844-396-7663), Option 3, for more information.
What is the cost of the test?
The cost of the test depends on your individual health insurance coverage (for example, in-network, out-of-network, co-insurance, deductible and co-pay)
Do you have a flexible payment plan?
Yes, we offer an interest-free payment plan over a period of up to 6 months.
Do you provide financial assistance to cover the cost of the test?
Yes, we do. Please contact our Patient Assistance Program team at email@example.com to learn more.
How do I make a payment?
Please call our billing department at 844-EXOSOME, Option 3, to arrange for payments. Screening tests are eligible for reimbursement with a flexible spending accoun (FSA), a health savings account (HSA), a health reimbursement arrangement (HRA), or a limited care flexible spending account (LCFSA).
We accept all major credit cards, checks and money orders
What if my insurance plan sends me a check directly for The EPI Test?
- Endorse the check by signing the back and writing the following under your signature: "Payable to Exosome Diagnostics, Inc."
- Please mail the check along with any cost-sharing, deductible or co-pay amounts and a copy of the Explanation of Benefits (EOB) to the following address:
Exosome Diagnostics Billing
PO Box 83405
Woburn, MA 01813-3405
This test was evaluated and its performance characteristics determined by Exosome Diagnostics, Inc. It has not been cleared or approved by the U.S. Food and Drug Administration (FDA). Exosome Diagnostics is certified under the Clinical Laboratory Improvement Amendments (CLIA) Act of 1988 as qualified to perform high complexity clinical testing. CLIA number – 22D2093470