Billing Information

Insurance Billing

Fulgent is committed to putting patients first by working side-by-side with our clients and their patients to provide access to quality genetic testing. We accept all commercial insurance plans and, whenever possible, will obtain the required prior authorizations.

What is Fulgent's billing policy?

Once we receive a sample or completed forms (see below), it is our practice to work with the provider and the patient on an individual basis. We will determine the patient's out-of-pocket cost for the genetic testing.

If a provider or patient wants to be notified for a different out-of-pocket amount, please indicate that on the test requisition.
(i.e. Please notify me if patient out of pocket exceeds $500 )

Testing will not be released until a reasonable path has been determined for reimbursement.

When can the verification of insurance coverage be done?

We can verify insurance coverage either before or after a sample is received in the laboratory.

Before the sample is received in the lab

To submit the required information, providers can:

Fulgent will fax the provider a summary once the process is completed.

After the sample is received in the lab

Authorization will be obtained before samples are processed by Fulgent. If the insurance does not cover testing, or if the out-of-pocket is expected to be more than $100, we will contact the patient within a week to discuss. Fulgent does offer financial assistance and no-interest payment plans.

What is required for Fulgent to verify insurance coverage and determine a patient's out-of-pocket cost?

  1. Copy (front and back) of the patient's healthcare insurance card (or cards if the patient has a secondary healthcare insurance plan).
  2. Completed test requisition form, including patient information: address, telephone number, etc. This is critical as orders not complete will require manual processing and could create an unnecessary delay. Insurance Billing Section
  3. Make certain that the appropriate ICD10 code(s) are included on the requisition form
  4. A clinical note, pedigree, and/or pertinent medical records that document the medical necessity of the genetic testing being ordered.

How does Fulgent verify coverage?

Fulgent accepts all private healthcare insurance plans. Fulgent will call the patient's insurance company to determine:

  1. If a prior authorization is required, Fulgent will submit the needed documentation (see below for what information needs to be submitted).
  2. What the patient's out-of-pocket cost will be. This includes unmet deductible, copay and coinsurance.

What is prior authorization?

Some insurance companies require a review of medical records before determining if genetic testing is covered by the plan. Fulgent will submit the medical information from the healthcare provider in an attempt to obtain a prior authorization.

In addition, certain insurance providers require a special authorization form to be completed by a genetics specialist if a specific test is being performed. To locate a genetic counselor in your area, please visit While Fulgent Genetics has certified genetic counselors on staff to answer your questions, it is important that an independent genetic counselor/specialist provide pre-test counselling to your patients. Please see below for the corresponding forms.

United Health Care (UHC)

Beginning in 2016, UHC requires prior authorization for BRCA genetic testing and should be completed by a Genetic Specialist (ie: genetic counselor, genetic nurse, clinical geneticist).


Aetna requires prior authorization to be completed by the ordering physician for tests that includes the BRCA genes.


Cigna has expanded the scope of requirements to most genetic testing including whole exome sequencing, hereditary cardiomyopathies/arrhythmias, microarray analysis, and hereditary cancer susceptibility. The following form should be completed by a Genetic Specialist (ie: genetic counselor, genetic nurse, clinical geneticist).

How does the insurance verification process impact turnaround-time?

Testing will not begin until:

  • Prior authorization for the testing is obtained (if required)
  • Patient agrees to the out-of-pocket amount (if more than $100).
Institutional Billing

How does Fulgent handle institutional billing?

To choose institutional billing, please completely fill out the Institutional Billing section of the requisition.

Organizations will be invoiced directly for services once testing has been completed. Please email, fax, or ship all corresponding documents with the sample.

How are Fulgent panels priced for institutions?

Rare Diseases Panels
(Singleton, Duo, Trio)
(Singleton, Duo, Trio)
Please call for other test offerings.
Institutional Billing Section
Medicare / Medicaid Billing

What if a patient has Medicare?

Fulgent is contracted with Medicare. However, Medicare has limited coverage for genetic testing.

What if a patient has Medicaid?

Fulgent is a registered provider with various Medicaid plans. However, these plans often do not cover the cost of genetic testing. Prior authorization is typically required.

  • If Fulgent has a contract with the Medicaid plan, we will submit the required information and attempt to obtain a prior authorization.
  • If we are not under contract with the Medicaid plan or if the test is not covered, we can offer our Medicaid Self Pay price.
  • If the patient has a Managed Medicaid plan, the provider is required to obtain the prior authorization per the plan requirements.
  • Any Medicaid test sent without a prior authorization will go on hold until a path for reimbursement has been determined.
Patient Self Pay

Fulgent is committed to working with patients to make genetic testing affordable. We offer cash pricing at a discounted rate to make our tests accessible to all patients. Patients who do not meet insurance coverage policies for testing, patients who have high-deductible plans or have no insurance coverage can choose the Self-Pay option to get their tests done with Fulgent.

  • Full payment or initial deposit if on a payment plan (Payment Plan Agreement is signed) must be made before test results can be released, either by credit card or check.
  • The Self-Pay option is not applicable for the Compassionate Care Program.

To take advantage of the self-pay price, select the "Self-Pay" option on our test requisition form and provide the patient's contact information. If ordering online, select the "Self-Pay" option in the billing portion of the ordering process. Fulgent will follow up with the patient directly regarding payment.

Patient Self Pay Section
Compassionate Care Program

Fulgent Genetics is a compassionate company offering a wide range of financial assistance programs based on the individual's financial need. These programs are available to patients in the United States who want to have their tests done with Fulgent. Patients must meet clinical and income criteria to apply for these programs.

Interest-free Payment Plans

Fulgent offers interest-free payment plans.

Economic Hardship

For patients with no medical insurance and limited financial resources to cover the cost of testing.

To apply for Economic Hardship please complete the Application For Economic Hardship and submit it to Fulgent Genetics via email or fax.

Fax 626-350-8802

Patient with Commercial Insurance

For patients who are insured with commercial insurance, Fulgent can offer financial assistance based on the criteria (see the Financial Disclosure Form for details). Patients with U.S. Federal and/or State funded health plans (i.e. Medicare, Medicaid, TriCare, Champus) do not qualify.

To apply for Financial Assistance, please complete the Financial Disclosure Form and submit it to Fulgent Genetics via email or fax

Fax 626-350-8802

If you have any questions about our billing process or any of Fulgent's programs, please contact our Client Service Team at or +1 (626) 350-0537 for more information.

For questions specific to insurance, medicare billing, contact a billing representative at or +1 (626) 434-3598 for more information.