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.
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
(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.
Fulgent accepts all private healthcare insurance plans. Fulgent will call the patient’s insurance company to determine:
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 www.nsgc.org. 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.
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).
Testing will not begin until:
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.
Fulgent is contracted with Medicare. However, Medicare has limited coverage for genetic testing.
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.
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.
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.
Please contact a Billing Representative at 626-434-3598 or firstname.lastname@example.org for more information.
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.
Fulgent offers interest-free payment plans for up to one year.
For patients with no medical insurance and limited financial resources to cover the cost of testing.
Application For Economic Hardship
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
Financial Disclosure Form
Remember that our Client Services Team is available to assist you. If you have any questions about our billing process or any of Fulgent's programs, please
Our mission is simple: to ensure all patients have access to important and clinically relevant genetic testing.
We believe in empowering patients and clinicians to make the most informed treatment decisions. Fulgent Genetics understands that costs associated with a patient’s testing can potentially pose a financial hardship which may influence a patient’s decision in selecting genetic testing options. Fulgent Genetics will always continue to provide all patients with access to cost effective genetic testing and promises to work one on one with each patient to meet their testing needs.