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.
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.
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).
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.
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.
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 size||Income range||Your 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)|
Insurance billing process
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.
|GENE||CPT code||CPT code description|
|CYP1A2||81479||Unlisted molecular pathology procedure|
|CYP2B6||81479||Unlisted molecular pathology procedure|
|CYP2C19||81225||Cyp2c19 gene common variants|
|CYP2C9||81227||Cyp2c9 gene common variants|
|CYP2D6||81226||Cyp2d6 gene common variants|
|CYP3A4||81230||Cyp3a4 gene common variants|
|CYP3A5||81231||Cyp3a5 gene common variants|
|SLCO1B1||81328||Slco1b1 gene common variants|
|NUDT15||81479||Unlisted molecular pathology procedure|
|OPRM1||81479||Unlisted molecular pathology procedure|
|COMT||81479||Unlisted molecular pathology procedure|
|DRD2||81479||Unlisted molecular pathology procedure|
|HTR2C||81479||Unlisted molecular pathology procedure|
|HTR2A||81479||Unlisted molecular pathology procedure|
|DPYD||81232||Dpyd gene common variants|
|GRIK4||81479||Unlisted molecular pathology procedure|
|IL28B (IFNL4)||81283||Ifnl4 gene|
|TPMT||81335||Tpmt gene common variants|
|SLC6A4||81479||Unlisted molecular pathology procedure|
|CYP2C Cluster||81479||Unlisted molecular pathology procedure|
|CYP4F2||81479||Unlisted molecular pathology procedure|
|HLAA||81381||Hla i typing 1 allele hr|
|HLAB||81381||Hla i typing 1 allele hr|
|MTHFR||81291||Mthfr 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.