Next-Generation Sequencing Panels Preauthorization

Overview

Upon receipt of a preauthorization request, an email will be sent to ordering provider or contact person listed on preauthorization form. To check the status of your patient's preauthorization, call 855.320.4869 or email ngsbill@uw.edu.

First, the preauthorization team will obtain benefits information and out-of-pocket estimate. Next, many cases will need medical review to confirm patient meets medical necessity criteria established by insurance payer; this can take a week or more. Once the preauthorization process is complete, out-of-pocket estimate is shared with provider, or if preferred, directly with the patient. Lastly, before testing begins, the ordering provider and/or patient must contact the preauthorization team to release the sample for testing.

Preauthorizations are handled in the order the requests are received. To expedite your preauthorization request, be sure to include:

• Preauthorization form
• Enlarged copy of patient's insurance card
• ABN, when applicable
• Supporting clinical documentation, such as clinic notes, pedigree, and/or letter of medical necessity

Templates for letter of medical necessity are available for the BROCA and ColoSeq™ Cancer Risk Panels. To receive the most up-to-date template, email a request to genelab@uw.edu.

Medicaid

University of Washington is able to bill Medicaid in some states. To see if Laboratory Medicine is able to bill Medicaid in your state, contact us at ngsbill@uw.edu.

Medicare

BROCA Cancer Risk Panel is covered for patients who meet Medicare genetic testing criteria for BRCA1/2, Lynch syndrome, or APC and MUTYH testing.

ColoSeq™ is covered for patients who meet Medicare genetic testing criteria for Lynch syndrome.

If BRCA1/2 testing has already been done and patient does not meet Medicare criteria for other genetic testing, an ABN is required. Similarly, if testing for Lynch syndrome or familial polyposis has already been done and patient does not meet Medicare criteria for other genetic testing, an ABN is required.

Self-Pay

Patients that are covering the entire cost of testing out-of-pocket may be eligible for a discount, if they pay for services in advance.

Further Information

• See Genetics and Solid Tumor Diagnostic Testing for info about other tests offered by our laboratory
• Lab telephone: 206.598.6429
• Supervisor: Robert Livingston, PhD
• Genetic Counselor: Angela Jacobson, MS, CGC
• Genetic Counselor: Sarah Paolucci, MS, CGC
• Genetic Counselor: Ginger Tsai, MS, CGC
• Director: Colin C. Pritchard, MD, PhD
• Director: Karen Stephens, PhD
• Director: Jonathan Tait, MD, PhD