Prior Authorization Billing

Molecular testing is a valuable tool in the evaluation and personalized treatment of patients with malignancies and inherited conditions. Molecular tests may be ordered by the client, or may be generated as a result of a consultation.

Applying for a prior authorization requires an insurance company be provided with sufficient information to support the clinical need for the test.

All requests for molecular tests must be accompanied by:

• Molecular Diagnostic Clinical History form
• Most recent pathology report
• Relevant clinic encounter notes
• Medical genetics consultation notes (if applicable)

Without a prior authorization, your patient’s claim for services may be denied which could result in your patient receiving a significant bill. MLabs will submit a prior authorization request on behalf of you and your patient so that this testing can be authorized and performed without significant delay. If an insurance company requires the prior authorization to be submitted by the ordering physician, we will contact you.