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.

2 Tests Ordered
10% off
total cost

3 Tests Ordered
15% off
total cost

4+ Tests Ordered
20% off
total cost

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

2 Tests Ordered
10% off
total cost

3 Tests Ordered
15% off
total cost

4+ Tests Ordered
20% off
total cost

Geographic availability: All USA except NY state

Eligible testing: All


Insurance Billing

Choose this Option:

If you are a patient paying out-of-pocket for testing and choosing to file an insurance claim using payment receipt.

MosaicDX testing is HSA and FSA eligible.

Authorizing practitioners must have an NPI for insurance to be filed.

  • Insurance is filed in the state where the referring practitioner’s NPI
    is registered or located.

How it works:

Patients makes payment for testing amount plus a $40 filing fee.

  • A single $40 filing fee would be applicable for multiple samples received from the patient on the same day.
  • Samples received and filed on separate claims would each be subject to separate $40 filing fees.

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

  • By filing a claim, MosaicDX is not guaranteeing reimbursement
  • A single $40 filing fee would be applicable for multiple samples received from the patient on the same day

Geographic availability: Please refer to insurance details section below for specific state plan limitations.

Eligible testing: Not all testing can be filed through insurance. Please refer to the insurance details below for specific limitations.

Insurance Options

Verify your expenses with your insurance company and determine if your plan is considered in-network to help calculate your out-of-pocket expenses. For any questions regarding insurance coverage, please call 913-341-8949 or 913-754-0459.

  • By filing a claim, MosaicDX is not guaranteeing insurance coverage
  • Always call your insurance provider to confirm benefits as insurance coverage is subject to change
  • BCBS insurance is filed in the state where the referring physician’s NPI is registered, or where the referring physician’s NPI is located
  • We require full patient cash price payment up-front PLUS a $40 filing fee per claim to be submitted along with the sample.

Plans and Tests Not Covered – cash pay required

MosaicDX will NOT file a claim with these insurance plans:

  • Blue Cross Blue Shield of: CA (XEH), FL, HI, IA, KS, LA, MS, MT, NE, NJ, NY, SD, and Capital Blue Cross (PA)
  • Anthem CA: Silver Direct Access Plan, Writers Guild, Directors Guild, Actors Guild
  • Empire BCBS (NY)
  • Capital Blue Cross (PA)
  • Aetna (all plans)
  • All Savers
  • Avmed
  • GEHA
  • Harvard Pilgrim
  • HMO plans
  • Horizon of New Jersey
  • Medicaid
  • Medicare
  • Medicare Advantage
  • ODS / Moda
  • Select Health
  • Regence Uniform
  • Tricare
  • Tufts
  • UMR
  • UHC of the River Valley
  • Veterans Health Adm.

Mosaic Diagnostics is not a participating provider in Medicare, Medicare Advantage, Medicaid, Medicaid Managed Care, Tricare or other government health benefit programs or plans. I understand if Medicare, Medicare Advantage, Medicaid, Medicaid Managed Care, Tricare or other government health benefit programs or plans are my primary insurance carrier, I will be considered “self-pay” and agree I will not submit my claim to my insurance.

These tests are NOT covered by ANY insurance plan

  • GPL-TOX Profile
  • MycoTOX Profile
  • Amino Acids Test (Plasma or Urine)
  • Calcium + Magnesium Test
  • DNA Methylation Pathway Profile
  • Glyphosate Test
  • Homocysteine Test
  • Iron + Total Iron-Binding Capacity Test (TIBC)
  • Kryptopyrrole Test
  • Omega-3 Index Complete
  • Porphyrins Profile

Restrictions – cash pay required

MosaicDX will NOT file claims for these tests to these insurance plans

Comprehensive Stool Analysis

  • Cigna
  • BCBS Illinois, Kansas City, Federal Employee Program

IgG Food MAP

  • Anthem BCBS California, Indiana, Virginia
  • Blue Cross Blue Shield CO, IL, MA, NC, PA, SC, TX, VT, WV, KC,
  • Federal
  • Blue Shield of California
  • Horizon of New Jersey

All Metals Testing

  • BCBS KC/Federal Employee Program

All Hormones Profiles

  • BCBS KC/Federal Employee Program

CPT Codes are also known as procedure codes and are how insurance will determine the nature of the test.

Test
CPT Code(s)
Adavanced Cholesterol Profile – Serum
82172*2 82465 83090 83695 83718
Amino Acids Plasma or Urine Test
82139*1 82140 84540
Calcium + Magnesium Test – Urine
82310 83735
CBC Test w/ Differential – Serum
85027
Comprehensive Stool Analysis – Stool
82272 82542 82656 8351 83631 83986 83993 85549 87045 87046 87102 87177*2 87209*2 87328 87329 89125 89160
Copper + Zinc Profile – Serum
82390 82525 84630
Hormones Comprehensive Profile
82670 84144 84402 82626 82530*4
Hormones Comprehensive Plus Profile
82679 82670 82677 84144 84402 82626 82530*4
IgE Allergy Advanced Combined Test (93/69) – Serum
86003*162
IgE Food Allergy Basic Test (25) – Serum
86003*25
IgE Food Allergy Advanced Test (93) – Serum
86003*93
IgE Inhalant Allergy Basic Test (36) – Serum
86003*36
IgE Inhalant Allergy Advanced Test (69) – Serum
86003*69
IgG Food MAP w/ Candida + Yeast (192) – Serum/DBS
86001*190 86628 86671
Metals Fecal Test (13)
82175 82300 82525 83015 83655 83825 83885
Metals Hair Test (39)
82108 82300 82525 83018*28 83655 83735 83785 83825 83885 84100 84255 84630
Metals Red Blood Cell Test (18)
82175 82300 82310 82495 82525 83015 83018*4 83655 83735 83785 83825 84100 84132 84255 84630
Metals Urine Test (38)
82108 82175 82300 82495 82525 82570 83018 83540 83655 83735 83785 83825 83885 84100 84133 84255 84300 84630
Metals Whole Blood Test (20)
82310 82495 82525 83018*7 83655 83735 83825 84132 84255 84285 84295 84630
Microbial Organic Acids Test (MOAT) (21) – Urine
82570 83921*20
Microbiology Test – Stool
87102 87106 87045 87046 87184 87220
Mold IgE Allergy Test (13) – Serum
86003*13
Omega-3 Index Complete – DBS
82542*24
Organic Acids Test (OAT) (76) – Urine
82131 82507 82570 83150 83497 83605 83921*66 83945 84207 84210 84585
Porphyrins Profile – Urine
84120*6
Streptococcus Antibodies Profile – Serum
83883 86215
Vitamin D Test – Serum
82306 82542

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.


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