How Billing Works
We've simplified our billing practices to increase transparency and streamline our services for providers and patients.
Patient Pay Options
Patient Self-Pay (Cash)
All patients have the option to pay cash for all lab tests; credit card or check payments are preferred. Payment in full is required at the time of service and must accompany the specimen and completed requisition form, otherwise, the specimen cannot be processed.
Please note: SpectraCell no longer accepts or submits claims for commercial or private health insurance, however, an itemized receipt will be issued upon request which patients may use to submit to their insurance provider for reimbursement. A patient can request a receipt after they have received their results by sending an email to email@example.com. Your request will be fulfilled within 48-72 hours.
Provider Pay Options
Provider Credit Card on File
This option is for clients who want to pay for the service directly on behalf of their patients. Clients are required to provide a valid credit card to remain on file by completing a credit card authorization form. Tests will be billed at the time the patient specimen is received or shortly thereafter. A detailed billing statement of the charge will be emailed to the client's email address provided on the credit card authorization form. It is the client's responsibility to notify SpectraCell Laboratories if the credit card on file needs to be updated.
If this payment option is selected on the requisition form and there is no credit card on file, the specimen cannot be processed.
SpectraCell no longer accepts Tricare as they have discontinued reimbursement on claims submitted.
SpectraCell will file claims directly to Medicare on behalf of patients as long as the following conditions are met:
- Medicare and Medicare Replacement Plans are the primary insurance
- The test is deemed medically necessary*
- The ordering provider has a valid National Provider Identifier (NPI) and is enrolled in PECOS
- A completed requisition form is received with valid ICD-10 diagnosis coding
- A copy of the patient's Medicare card is provided with the completed requisition
- A signed ABN form is provided (found on the reverse side of the lab requisition form)
If a client participates in the Medicare option and fails to comply with the requirements outlined above, the client will be billed at the Provider Credit Card on File rate. Additionally, we won't be permitted to adjust the method of payment retroactively.
*Limited coverage tests ordered without medical necessity will result in the patient receiving a bill according to the pricing dictated by Medicare on the ABN.
Frequently Asked Questions
Find the quickest answers to questions about our billing procedures and support.
You may call our billing department at 1-800-227-5227, Option 4. For a faster response, please send a message to firstname.lastname@example.org.
After you have received your results, you may request an itemized receipt by sending an email to email@example.com. Your request will be fulfilled within 48-72 hours.
Medicare covers everything but the Antioxidants and B Vitamins section of the panel as indicated on our lab requisition form. A patient's out of pocket expense for the full panel will be $110.
Below is a list of the Micronutrient analytes statutorily not covered by Medicare and Medicare Replacement Plans:
- Lipoic Acid
- Vitamin B3
- Fructose Sensitivity
- Glucose-Insulin Interaction
Medicare only covers laboratory services that are ordered by PECOS registered practitioners and deemed medically necessary by Medicare. A Medicare patient may be responsible for the cash price of the test if:
- The test is likely to be denied coverage by Medicare and the patient selects Option 2 on their Advanced Beneficiary Notice (ABN).
- The test is statutorily not covered by Medicare.