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Understanding Natera’s Genetic Testing Bill for Women’s Health Tests

At Natera, we believe that genetic testing should be available to everyone who can benefit from it. Our genetic tests provide valuable information across a wide spectrum of women’s health needs—from preconception planning to prenatal testing to hereditary cancer screening. 

We understand that the cost of genetic testing has historically been a barrier for many people. Natera is committed to working with all patients to ensure that cost does not prevent them from getting a test they need.

We also appreciate that navigating the healthcare billing process can be difficult, with or without insurance. We believe that it is important to inform patients of what to expect to make the process easier.

We deliver more than one million test results each year to individuals and families. We seek to provide a positive experience for everyone who needs genetic testing. That’s why we aim to work with individuals and families to ensure they can access and afford the right test for them.

How Natera’s Billing Practices Work for Women’s Health Tests

If you have received or are planning to receive a Natera genetic test, you may be wondering what to expect during the billing process. 

Getting a Personalized Cost Estimate

It’s common for patients to speak with their doctors about the cost of genetic testing before opting to get tested. Your doctor is a great resource, but may not be able to give you the most accurate information about the cost of every Natera test or what you might expect to pay. Your final cost, which will be stated on your Natera genetic testing bill, usually depends on your insurance coverage, which may be different across your doctor’s other patients. 

For Panorama™, Empower™, Vistara™, and Horizon™, you can request a personalized Natera genetic testing bill estimate before submitting your sample by emailing estimate@natera.com or texting 1-650-210-7046. The estimate will either indicate how much you may be expected to pay out of pocket (if you provide insurance information), or what your self-pay cost will be (if you do not have insurance).

While Natera strives for accuracy, your personalized cost estimate is just that—an estimate, and can change depending on many factors, such as the specific type of screening panel that is selected, your deductible, Natera’s negotiated rate with your insurance plan, and other factors. 

Self-Pay Pricing

Natera offers an affordable self-pay price for patients. If you have insurance and your personalized cost estimate reflects an out-of-pocket cost that exceeds our self-pay price (in the case of high-deductible plans, for example), Natera will attempt to contact you via our Price Transparency Program to discuss your payment options. 

If you have an option between self-pay and insurance, you may receive a communication that requests a decision within 3-5 business days. If you do not respond, we will default to billing your insurance. Once a claim has been submitted to your insurance, you can no longer choose the self-pay option.

Billing Your Insurance

Natera is an in-network laboratory for the majority of health plans, including Aetna, Anthem, Cigna, and UnitedHealthCare. A full list of insurance plans that contract Natera as an in-network laboratory is available here. We accept all national and regional carriers in the United States. Check with your insurance company prior to testing to determine whether we are an in-network or out-of-network provider. If you choose to bill through your insurance provider, there are a few extra steps to Natera’s billing practices that are helpful to understand.

Understanding Your Insurance Coverage for Genetic Testing

After Natera reviews and submits the claim for your genetic test, your insurance company processes it according to their guidelines and the parameters of your individual health plan. This process can vary between insurance plans, even between plans issued by the same insurance company.

If Natera is designated as in-network for your insurance plan, this does not always mean that 100% of the cost of testing will be covered by your plan. The total amount you will owe is determined by your individual health plan. We recommend contacting your plan’s Member Services department for more information about how your insurance plan calculates the amount you will owe (the number for Member Services is usually found on the back of your insurance card). 

Navigating Prior Authorization

Many health plans require your doctor to request prior authorization, sometimes called precertification or preauthorization, for certain tests, healthcare services, and medications. 

If your plan requires prior authorization for genetic testing, it means that your insurance company must review the Natera test and reason for ordering it before determining whether they will cover it. 

If Natera submits a claim to your insurance company and a necessary prior authorization has not been issued, your insurance company may deny the claim and decline to pay the bill. If prior authorization is denied, Natera may offer you the self-pay price for your specific genetic test.

Do I Need Prior Authorization?

Ask your doctor whether you will need prior authorization for your genetic test. If they aren’t sure, they likely have a billing office or prior authorization department that can check with your health plan. If you want to check yourself, call your plan’s Member Services department or see if they have an online tool that can help determine whether you will need prior authorization. 

Who Orders a Prior Authorization?

Either the doctor or the laboratory that orders the test is generally responsible for submitting the request for prior authorization. Patients are rarely able to submit their own requests. Check with your health plan to see who is responsible for submitting the request.

If the prior authorization request needs to come from your provider’s office, your doctor will provide specific information about your health to the insurance plan, as well as the medically necessary reason for ordering the genetic test.

Do I Need to Meet With a Genetic Counselor Before Getting My Test?

Some health plans require patients to meet with an independent genetic counselor before a prior authorization request will be approved. In this case, the genetic counselor may be the one submitting the prior authorization request, instead of your doctor’s office. 

Regardless of your insurance requirements, you always have the option to schedule a complimentary information session with one of Natera’s board certified genetic counselors. To speak to a genetic counselor, please use our scheduling tool here. 

What Happens if Prior Authorization is Not Obtained?

If a prior authorization request is submitted but is denied, you will be notified of the denial by your insurance company. 

You may be provided information about how to initiate a reconsideration request or appeal of the denial. The appeal process differs between insurance plans, so it’s always best to follow their instructions carefully and contact your plan directly with any questions.

Natera will work with you and your insurance provider to solve any problems and ensure that you are billed correctly. If prior authorization is denied, Natera may offer you the self-pay price for your specific genetic test.

You can contact Natera billing at 1-844-384-2996 (8 am-7 pm Central Time Monday-Friday) or through our webform. 

What Happens When Prior Authorization is Approved?

There is no guarantee that your insurance will cover 100% of the costs even if the prior authorization is approved. You will still be responsible for your share of the costs as specified by your health plan. It’s always best to check with your health plan directly when anticipating your out-of-pocket costs.

What is an Explanation of Benefits (EOB)?

After your Natera test has been completed, a claim has been submitted to your insurance, and your insurance company has processed it, your insurer will send you an Explanation of Benefits (EOB) document. An EOB is not a bill, even though it may look like one.

Your EOB is intended to inform you that charges have been filed on your behalf and show you how your insurance company processed the claim that Natera submitted to them. It provides an outline of the claim amount and the amount that your plan covers. As with most medical services, the amounts that Natera claims for a test are pre-negotiated with your insurance company and are different from Natera’s discounted self-pay prices. 

Some of the information you can expect to find on your EOB includes:

  • The services (tests) you received and the date

  • The dollar amount of the claim submitted by Natera to your insurer

  • How much your insurance plan covers

  • How much you may be expected to pay. 

    • This amount will vary based on whether your test is a covered benefit and your individual plan parameters. If your insurance does not cover the test in any capacity, the insurance company will direct Natera to bill you for the full test price. In this case, you may work with Natera to discover what other payment options you may have.

Your EOB is not a bill and should not be treated as one. It simply describes how you and your insurance plan will share the cost of a medical test or procedure. Even though it contains an amount that you may be expected to pay, this amount may not be final. There may be further discounts that Natera can negotiate with your insurer, or that you may qualify for under our Financial Assistance Program.

When Will I Find Out My Final Cost?

The final amount that you owe, if anything, will be outlined on a separate bill that comes from Natera—not from your insurance company. This separate bill from Natera will be delivered on Natera letterhead. 

We recommend waiting for this bill before contacting Natera or sending payment for the amount given on your EOB. No action is required until you receive your final bill from Natera. 

The due date for your payment is 30 days after the invoice date. The invoice date is stated on your bill. If you have any questions about the amount you are ultimately billed, please contact us at the Natera billing phone number (1-844-384-2996) or through our webform.

Choosing Self-Pay

If you don’t have health insurance or choose for any reason not to bill a Natera test to your insurance, you can elect to pay a self-pay rate. 

For questions regarding self-pay, please contact Natera directly for a personalized cost estimate prior to initiating testing. The Natera billing phone number is 1-844-384-2996 and is reachable 8am-7pm CT, Monday-Friday.

Interpreting Your Natera Bill

Following testing, you will receive a bill in the mail from Natera. If you opt for self-pay, your bill will arrive shortly after your test results. If you are using your insurance, your bill will arrive after your claim has been processed by your insurance company. 

Your bill will have the following information:

  • The name of the genetic test you received

  • Your physician’s information

  • The date the test was ordered

  • Your case number

  • The amount due

  • The date your bill was issued and the date it is due

  • Your insurance provider (if any)

Your Natera bill indicates the total cost of your testing as well as any deductions and your final owed amount. If you have any questions, please contact Natera at 1-844-384-2996 or through our webform.

Your payment will be due 30 days after your bill is issued. Bills can be paid online, by phone, or through mail using the information provided on your bill. Please have your case number handy if you call the Natera billing phone number to help our representatives locate your bill. 

Financial Access Programs

We understand that healthcare can be a significant financial burden for some families. That’s why Natera offers financial assistance for people who qualify for our Compassionate Care program. Based on your annual household income, you may qualify for reduced patient responsibility, between $0 and $149. You may still qualify for financial assistance even if you have health insurance, depending on your circumstances. Natera also offers the option of an interest-free payment plan. 

To apply for Compassionate Care, you can:

After your application is received, Natera reviews your information to determine whether you are eligible for financial assistance. 

Natera is Here To Help

Natera provides genetic tests that enable you and your doctor to make more informed decisions about your health. Our mission is to make personalized genetic testing a healthcare reality for every patient. Whatever your financial situation, our team is here to assist you.

For questions about what you will see with Natera’s genetic testing bill, please contact us at 1-844-384-2996 or through our webform.