Billing information

OneOme’s mission is to provide the most cost-effective, pharmacogenomic testing and tools for providers across the globe to use in everyday patient care. In order to achieve this goal, we offer multiple billing options.

Billing options

At OneOme, our goal is to provide every patient with access to pharmacogenomic testing. That’s why we’ve created a billing process that supports different payment options, depending on how the test is ordered, including:

Our client services team is available to work with you to find the best billing option for your scenario. CONTACT US for more information or review our billing FAQs.

Patient self-pay (U.S. only)

For tests ordered by a patient’s provider, patients may pay for the test directly at the time the provider submits the order, or OneOme can contact the patient to collect payment after the provider submits the order. OneOme accepts payments from all major credit cards, HSA accounts, and PayPal. In addition, we offer interest-free payment plans when needed. Please CONTACT US for more information about interest-free payment plans.

Please note that the sample will not be processed until payment is collected or a payment plan has been established.

For RightMed tests ordered through the independent provider network, OneOme accepts payment from credit cards, HSA accounts, and PayPal (insurance billing is not available for this option).

Institutional billing

We will bill institutions directly at our current list price without a contract. Discounted pricing is available with a contract. Testing is not invoiced until a report has been delivered. We offer a variety of payment options including check, credit card, or wire transfer. Please CONTACT US for more information.

Insurance billing

OneOme accepts all insurance plans. Our goal is for a patient to access the lowest cost option available to them. Depending on a patient’s insurance coverage, their maximum out-of-pocket cost will vary.

Medicare, Medicaid, and TRICARE
For government-funded insurance programs, such as Medicare, Medicaid, Managed Medicaid Plans, or TRICARE, a patient’s out-of-pocket cost will be $0. Medicare Advantage plans may have a copayment or deductible requirement.

Private insurance
For private insurance plans, OneOme will determine if a patient qualifies for financial assistance. If a patient doesn’t qualify, OneOme will contact the patient prior to submitting the insurance claim to discuss alternative options, including patient self-pay.

OneOme Financial Assistance Program (FAP)
OneOme offers financial assistance to reduce out-of-pocket costs for qualified patients in the U.S. to $349 or less. To be eligible patients must have private insurance and meet income requirements (household incomes up to 600 percent of the Federal poverty level). The chart below breaks down the cost of the RightMed test based on household size and income.

PRIVATE INSURANCE UNDER FAP
Household sizeIncome rangeYour RightMed test cost
1$0 - $24,280$149
$24,281 - $48,560$249
$48,561 - $72,840$349
$72,841 +OneOme offers patient self-pay ($349)
2$0 - $32,920$149
$32,921 - $65,840$249
$65,841 - $98,760$349
$98,761 +OneOme offers patient self-pay ($349)
3$0 - $41,560$149
$41,561 - $83,120$249
$83,121 - $124,680$349
$124,681 +OneOme offers patient self-pay ($349)
4$0 - $50,200$149
$50,201 - $100,400$249
$100,401 - $150,600$349
$150,601 +OneOme offers patient self-pay ($349)
5$0 - 58,840$149
$58,841 - $117,680$249
$117,681 - $176,520$349
$176,521 +OneOme offers patient self-pay ($349)
6$0 - $67,480$149
$67,481 - $134,960$249
$134,961 - $202,440$349
$202,441 +OneOme offers patient self-pay ($349)
7$0 - $76,120$149
$76,121 - $152,240$249
$152,241 - $228,360$349
$228,361 +OneOme offers patient self-pay ($349)
8$0 - $84,760$149
$84,761 - $169,520$249
$169,521 - $254,280$349
$254,281 +OneOme offers patient self-pay ($349)
Income values are pre-tax and based on 2018 poverty guidelines for the 48 contiguous states and the District of Columbia

Insurance billing process

  • OneOme reviews the patient’s insurance information to make sure it is complete and accurate.
  • OneOme will confirm insurance requirements, and if applicable, pre-qualify a patient for financial assistance
  • OneOme will contact the patient prior to submitting a claim if they don’t qualify for financial assistance, or if any additional information is needed.
  • If the patient does qualify for financial assistance, OneOme sends an informational letter to the patient describing the process and what to expect.
  • OneOme submits the insurance claim directly to patient’s insurance company, once the order is processed.
  • Patient receives an explanation of benefits (EOB) from their insurance company in the mail. The EOB is NOT a bill, but an explanation of what was covered.
  • If coverage is denied or only part of the test is covered, OneOme will appeal the decision on behalf of the patient.
  • After a final coverage decision from insurance is made, a patient may receive an invoice from OneOme for any deductibles, coinsurance, copayments, and for services deemed non-covered or ineligible under their insurance policy.

Billing codes
It is the responsibility of the submitting party to determine the correct billing codes to use when filing billing claims to third-party insurance. Below is a list of relevant codes.

GENECPT codeCPT code description
CYP1A281479Unlisted molecular pathology procedure
CYP2B681479Unlisted molecular pathology procedure
CYP2C1981225Cyp2c19 gene common variants
CYP2C981227Cyp2c9 gene common variants
CYP2D681226Cyp2d6 gene common variants
CYP3A481230Cyp3a4 gene common variants
CYP3A581231Cyp3a5 gene common variants
SLCO1B181328Slco1b1 gene common variants
UGT1A181350Ugt1a1 gene
VKORC181355Vkorc1 gene
F281240F2 gene
NUDT1581479Unlisted molecular pathology procedure
F581241F5 gene
OPRM181479Unlisted molecular pathology procedure
COMT81479Unlisted molecular pathology procedure
DRD281479Unlisted molecular pathology procedure
HTR2C81479Unlisted molecular pathology procedure
HTR2A81479Unlisted molecular pathology procedure
DPYD81232Dpyd gene common variants
GRIK481479Unlisted molecular pathology procedure
IL28B (IFNL4)81283Ifnl4 gene
TPMT81335Tpmt gene common variants
SLC6A481479Unlisted molecular pathology procedure
CYP2C Cluster81479Unlisted molecular pathology procedure
CYP4F281479Unlisted molecular pathology procedure
HLAA81381Hla i typing 1 allele hr
HLAB81381Hla i typing 1 allele hr
MTHFR81291Mthfr gene com variants

OneOme’s tests were developed and their performance characteristics have been determined by OneOme, LLC, a clinical laboratory located at 807 Broadway Street NE, Suite 100 Minneapolis, MN 55413. They have not been cleared or approved by the U.S. Food and Drug Administration. OneOme is regulated under CLIA-88 as qualified to perform high-complexity testing. These tests are used for clinical purposes and should not be regarded as investigational or for research.