Benefits Investigation and Prior Authorization
At HNL Lab Medicine, we take the complexity out of billing so that you can focus on what matters most; your patients’ health.
For select genomic and molecular assays, when your provider orders the test, we’ll check with your patient’s insurance provider to make sure the test is covered and give them a full picture of what their out-of-pocket cost may be.
Prior Authorizations
Many third-party payers require prior authorization for patients in need of important genetic and molecular laboratory testing. Without prior authorization, your patient’s claim for reimbursement of the test will be rejected, and they may receive a significant bill.
While most insurance providers require the ordering physician to obtain prior authorization, HNL Lab Medicine aims to reduce your administrative burden by assisting with this process when permitted by the patient’s insurance plan. We will submit a prior authorization request on behalf of you and your patient to help ensure that testing is approved, completed, and reimbursed without unnecessary delays or unexpected out-of-pocket costs.
The prior authorization process requires that the insurance company is providing necessary clinical information to support the clinical need for the test. In order to simplify the process, you can utilize this prior authorization packet to easily collect the relevant information that we may convey to the insurance company. If we need additional information, an HNL Lab Medicine representative will reach out to your office.
HNL Lab Medicine will process the patient’s specimen to ensure stability of the specimen but may hold the specimen and not complete the test until all information for the prior authorization is received.
