Payment and Billing

All Metametrix services must be ordered by a qualified healthcare provider.

Metametrix offers a choice of pricing plans, determined by the payment method chosen by you and your patient. This will be reflected on the Test Requisition Form that is submitted with the specimen. Pricing information will only be provided to healthcare providers upon request. Prices are not posted on this website. Patients should direct all questions about the cost of testing to their ordering healthcare provider.

Three payment options are outlined below:

1. Clinician Billing*

   Clinician billing is at the clinician's discretion. In this option, the patient will pay their clinician directly for the testing services. The clinician will then be billed by Metametrix and be responsible for payment.

   *Exception - New York State: Clinicians in New York State are unable to bill patients for laboratory services. All New York patients must use the pre-pay option.

2. Patient Prepay

   Pre-payment of testing offers a discounted rate for the patient. The test must be paid in full with the submittal of specimen and Test Requisition Form. If insurance information is provided, a complimentary filing will be done by Metametrix.

   Note: We do not bill patients.

   Acceptable payments: Patient's or healthcare provider's Visa/MC/AMEX/Discover, money order, or check payable to Metametrix Inc.

3. List Price

   The 'List Price' is the full list price of the test or profile if not selecting the prepay clinician billing option. Metametrix will file medical claims for patients with private insurance, Medicare, or Cigna using the list price. Please note that 20% of the list price is required with specimen submission. The patient is liable for the remainder of the list price not covered by insurance.

PrePay Advantage: A Courtesy Insurance Filing Program

Metametrix offers a courtesy insurance filing program for all patient prepaid test submissions. Metametrix will submit insurance claims as a courtesy for patients that include full payment at the "Patient Prepay" price with specimen submission. This does not guarantee reimbursement from the insurance provider. If the courtesy filing is denied, the patient will receive a letter with the reason for rejection from Metametrix and an explanation of benefits from their insurance provider. They may then provide missing information or appeal rejection directly with their insurance provider, if needed.

For Metametrix to complete the complimentary filing we require the following:

• Full payment (patient prepay amount) submitted with the specimen and Test Requisition Form
• All required insurance information filled out on the Test Requisition Form in section eight, 'Responsible Party Insurance' Information and a copy of the insurance card
• ICD-9 codes provided in section six by the ordering clinician. A listing of ICD-9 codes can be found here.
• A valid NPI number of the ordering clinician

Prepay insurance billing is a value-added service with benefits to clinicians and patients:

• Reducing pricing, billing, and collections confusion
• Applicable to any testing services provided by Metametrix
• Since patients are prepaying, they are not liable for any additional charges regardless of the amount covered by insurance
• Insurance reimbursements are typically faster when filed by the service provider and will be paid by the insurance company directly to the patient

For more information on this value-added service, please contact Client Services at 800.221.4640. For Guidelines on the best use of the program download our PrePay Advantage Claim Submissions Guidline (PDF).

Exception - New York clients must use the Patient Prepay option when ordering testing. PrePay Advantage can also be used by New York patients.