Payment Methods and Procedures

Practitioner Pay

Choose this Option:

If you are a practitioner who plans to pay MosaicDX directly for testing and collect reimbursement directly from your patients.

How it Works:

For office inventory: Submit payment information for your testing upfront, charges applied after the sample is received at our lab.

For drop ship to patients: Submit payment information for your testing upfront, charges applied when the order is placed.

An order statement containing pricing before any adjustments will be provided.

Multi-Test Discount:

Every MosaicDX test is eligible for the multi-test discount. For 2 tests placed for the same patient at the same time, a 10% discount will be applied to the total cost of both tests; for 3 tests, a 15% discount will be applied; and for 4 tests or more, a 20% discount.

Geographic availability: All USA except NJ, NY and RI.

Eligible testing: All

Patient Pay

Choose this Option:

If you are a patient who plans to pay for testing yourself, you have the option to make a direct payment to MosaicDX.

MosaicDX tests are eligible for HSA and FSA.

How it Works:

After your practitioner has initiated the order, you’ll provide payment information during kit registration. The charge will be processed either before your kit is shipped to you or, if you already have your kit, when your sample arrives at the lab.

Multi-Test Discount:

Every MosaicDX test is eligible for the multi-test discount. For 2 tests placed for the same patient at the same time, a 10% discount will be applied to the total cost of both tests; for 3 tests, a 15% discount will be applied; and for 4 tests or more, a 20% discount

Geographic availability: All USA except NY state

Eligible testing: All

Insurance Billing

As of March 1, 2025, MosaicDX will no longer file claims on behalf of the patient. 

If you wish to file a claim on your own behalf and would like to request a superbill, please email your request to Billing@mosaicdx.com.

• Please allow 3-5 business days for your request to be completed.
• Superbills will be sent to the patient or patient’s guarantor only.

How it works:

• Patient pays for tests at the time of ordering.
  • Superbills will only be provided once the test is paid in full.
  • Please wait to submit your request until after the order has been fully processed and results have been finalized.

• Patient requests a superbill to submit to their insurance company. The patient submits superbill to their insurance company.
  • MosaicDX does not guarantee insurance coverage.
  • Always call your insurance provider to confirm benefits as insurance coverage is subject to change.

• Superbills are only available if the practitioner provides diagnosis (ICD-10) codes.
  • It is the responsibility of the patient to ensure the diagnosis codes are provided by the practitioner to MosaicDX.
    • If diagnosis codes are not provided an itemized statement will be provided in lieu of the superbill.
  • Ordering practitioners must have an NPI (National Provider Identifier) for a superbill to be provided.
    • If the ordering practitioner does not have an NPI an itemized statement will be provided in lieu of the superbill.

• MosaicDX is not a participating provider in Medicare, Medicare Advantage, Medicaid, Medicaid Managed Care, Tricare or other government health benefit programs or plans.

• If you are covered by Medicare, Medicare Advantage, Medicaid, Medicaid Managed Care, Tricare or other government health benefit programs you will be considered “self-pay” and will be required to agree you will not submit your claim to these insurance types.

Eligible testing: 

Not all testing can be filed through insurance. MosaicDX is unable to provide CPT codes for the following tests.

• TOXDetect Profile™
• DNA Methylation Pathway Profile
• Glyphosate Test
• Homocysteine Test
• Iron + Total Iron-Binding Capacity Test (TIBC)
• Kryptopyrrole Test

If the patient’s test is covered by their insurance, any reimbursement will be sent directly to the patient from their insurance carrier.

Key steps to file a medical claim on your own behalf:

• Contact your insurance company to check for their claim submission options.
• Most insurance companies will accept a superbill by fax or mail. Some insurance companies will provide upon request, a claim form to complete or by completing an online form for submission.
• To submit a superbill for consideration to your insurance company, you must have diagnosis codes and CPT codes for each test.
• MosaicDX will provide the CPT codes for eligible tests (See list of exclusions).
• Diagnosis codes must be provided by the practitioner.
  • It is the responsibility of the patient to ensure the diagnosis (ICD-10) codes are provided by the practitioner to MosaicDX.

Important considerations:

• Check your policy:
• Always review your insurance policy to understand what services are covered and claim filing deadlines. 
• Out-of-network providers: MosaicDX is a non-participating provider and not in network with any insurance providers.

For out-of-network providers, you may be responsible for a higher out-of-pocket cost. 

• Claim review and appeals:
• If your claim is denied, review the reason and consider appealing the decision if you believe it’s incorrect. 

Pricing

Patient Pricing: For pricing information on our laboratory testing, reach out to your healthcare provider. If you don’t have a practitioner, contact our customer service team and they can connect you with one in your area.

North American and Canada Practitioner Pricing: Contact us at sales@mosaicdx.com

Acceptable Payment Methods

Payment must accompany all specimens for processing.

• All major credit cards including Visa, Master Card, Discover, American Express, JCB, and Diners Club
• Health Saving Accounts (HSA) and Flexible Spending Accounts (FSA) with Visa, Mastercard, Discover or American Express
• Check or Money Order
• Wire Transfer

Cancellation Policy

At MosaicDX, our commitment is to provide efficient and accurate testing services to our clients. We understand that circumstances may necessitate test cancellations, and to facilitate a streamlined process, we have established the following cancellation policy:

To request the cancellation of any test(s), notification must be provided to MosaicDX by the ordering practitioner, patient, or parent/guardian.

Initiating Cancellation and Acceptable Timeframes

For cancellation requests submitted more than 24 hours after the laboratory received the specimen, no refund will be made.

When Specimen has not shipped to MosaicDX
Practitioners and patients can cancel an unpaid test order before it has shipped to MosaicDX through their portal login. 

Practitioners and patients can cancel a test order before it has shipped to MosaicDX through their portal login, or by using this cancellation form. A refund will be issued, deducting a $35 cancellation fee. 

If you cancel an international order, we will deduct $35 for the cancellation fee and 50% of the shipping costs from your refund.

When Specimen has shipped to MosaicDX
Cancellations of specimens that have shipped to Mosaic will be accepted only if requested through this cancellation form and within 24 hours of the laboratory receiving the specimen. It is crucial to note that our testing process commences promptly upon specimen receipt. Upon approval of the cancellation, a refund will be issued, deducting a $75 cancellation fee. 

If you cancel an international order, we will deduct $75 for the cancellation fee and the shipping costs from your refund.

Refund Approval and Processing

Upon receiving and reviewing the refund request, our team will evaluate eligibility according to the policy guidelines. If the request aligns with the policy criteria, the refund will be processed within 7 days of the approval date and confirmation will be sent to the requesting party or designated contact. Refunds will be issued using the original payment method unless otherwise specified or agreed upon.

Policy Acknowledgment

By utilizing MosaicDX’s services and submitting specimen(s) for testing, clients, practitioners, patients, and/or parent/guardians acknowledge their understanding and agreement to adhere to this cancellation policy.