We are committed to working with patients. CDx offers numerous payment options including flexible payment plans and financial assistance.

Click here for information about the Financial Assistance Program.

Your Explanation of Benefits (EOB) is like a receipt that shows what happened when you used your health insurance. You'll get one after each visit to your doctor, hospital, or when you get medical supplies.
AN EOB IS NOT A BILL.

It breaks down:

• What services or items you received
• How much your insurance plan paid
• How much you might need to pay

This isn't a bill - it's just letting you know what's happening with your insurance coverage. If you do need to pay anything, you'll get a separate bill from your healthcare provider.

Here are the components of your medical bill.

Service/Product
The tests you received from your healthcare provider.

Dates of Service
The date your care happened or when samples were taken.

Amount Billed
The full price your provider charged to your insurance company.

Amount Allowed
The price your insurance company and your provider have agreed is fair for this service. This is usually less than the original billed amount.

Deductible
Think of this like a yearly starter payment. It's how much you need to pay for your healthcare before your insurance starts helping with the costs. For example, if your deductible is $1,000, you pay the first $1,000 of your covered medical costs each year.

Copay
Your fixed share of the cost. For example, you might pay $25 every time you see your doctor, and your insurance pays the rest.

Coinsurance
After you've paid your deductible, you might still need to pay a percentage of each medical bill. For example, your insurance might pay 80% and you pay 20%.

Amount Not Covered (Denied)
Parts of your bill that your insurance won't pay for. This could be because:

• It needed pre-approval and didn't get it
• It's not included in your insurance plan
• The claim was submitted twice by accident

Amount Paid
By Your Health Plan The amount your insurance company covered after subtracting your share (copay, deductible, and coinsurance).

Your Total Responsibility
Your share of the bill. This might include:

• Your copay
• Part of your deductible
• Your coinsurance
• Any services your insurance didn't cover Important: If your insurance company sent you money that was meant for your provider, you need to pay that amount to your provider.

Claim Notes
These are helpful explanations about your bill, like why something wasn't covered or how the payment was calculated. They help you understand what happened with your claim.

The maximum patient responsibility for self-pay is:

$880.00 per/WATS3D biopsy

$807.35 per/OralCDx Brush Biopsy

No Surprises Act

Your Rights and Protections Against Surprise Medical Bills

When you get emergency care or get treated by an out-of-network provider at an in-network hospital or ambulatory surgical center, you are protected from surprise billing or balance billing.

What is “balance billing” (sometimes called “surprise billing”)?

When you see a doctor or other health care provider, you may owe certain out-of-pocket costs such as a copayment, coinsurance, and/or a deductible. You also may have other costs or have to pay the entire bill if you receive care from a provider that is “out-of-network” for your health plan’s network.

“Out-of-network” means the provider has not signed a contract with your health plan to provide services.  Out-of-network providers may be allowed to bill you for the difference between what your plan agreed to pay and the full amount charged to the plan for a service. This is called “balance billing.” This amount may be more than in-network costs for the same service and might not count toward your annual out-of-pocket limit.

“Surprise billing” is an unexpected balance bill. This can happen when you can’t control who is involved in your care—like when you have an emergency or when you schedule a visit at an in-network facility but are unexpectedly treated by an out-of-network provider that you do not or cannot choose.

You are protected from balance billing for:

Emergency services

If you have an emergency medical condition and get emergency services from an out-of-network provider or facility, the most the provider or facility typically may bill you is your plan’s in-network cost-sharing amount (such as copayments and coinsurance). You can’t be balance billed for these emergency services. This includes services you may get at the facility caring for you after you’re in stable condition.

Certain services at an in-network hospital or ambulatory surgical center

When you get services from an in-network hospital or ambulatory surgical center, certain providers there may be out-of-network. In these cases, the most those providers may bill you is your plan’s in-network cost-sharing amount. This applies to emergency medicine, anesthesia, pathology, radiology, laboratory, neonatology, assistant surgeon, hospitalist, or intensivist services. These providers can’t balance bill you and may not ask you to give up your protections not to be balance billed. 

If you get certain other services at these in-network facilities, out-of-network providers can’t balance bill you, unless you give written consent and give up your protections.

Effect of Specific State Rules

Some states have their own laws relating to balance or surprise billing for out-of-network laboratory or pathology services that may be different from those described here, including the states listed below. The links below contain state specific balance billing information and resources, including contact information for state agencies that may be able to help you further. 

You’re never required to give up your protections from balance billing. You also aren’t required to get care out-of-network. You can choose a provider or facility in your plan’s network.  

When balance billing isn’t allowed, you also have these protections: 

• You are only responsible for paying your share of the cost (like the copayments, coinsurance, and deductibles) that you would pay if Labcorp was in-network. Your health plan will pay Labcorp directly.
• Your health plan generally must:
  • Cover emergency services without requiring you to get approval for services in advance (prior authorization).
  • Cover emergency services by out-of-network providers.
  • Base what you owe the provider or facility (cost-sharing) on what it would pay an in-network provider or facility and show that amount in your explanation of benefits.
  • Count any amount you pay for emergency services or out-of-network services toward your deductible and out-of-pocket limit.

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  If you think you’ve been wrongly billed: you may file a complaint with the federal government at https://www.cms.gov/nosurprises/consumers or by calling 1-800-985-3059; and/or file a complaint with your state balance billing regulator, if any, which is identified in the state-specific tabs. 

  Visit https://www.cms.gov/nosurprises for more information about your rights under federal law or visit your home state regulator’s website (included in state links above) for more information about your state balance billing rights.