We want kidneyintelX.dkdTM to be
We know how important it is to have access to a test that can help you understand whether or not you are at risk for worsening kidney disease. Through our clinical laboratory services, we are empowering patients to get the answers they need to preserve their kidney health.
Payment Options & Support
Pay Bill Online
Patient Protection: No Surprise Costs
Claims & Coverage Decisions
Choose a payment option that works for you.
We have an assortment of payment plans and provide financial assistance, all designed to help patients get the care they need and deserve. You can even find flexible, interest-free payment plan options which may work best.
Concerned about cost?
We may be able to reduce out of pocket costs for qualified uninsured and underinsured patients who meet the criteria for a kidneyintelX.dkd test.
Complete the attached form today to see if you qualify.
You’re protected from surprise charges.
The No Surprises Act. Your Rights and Protections Against Surprise Medical Bills.
When you get emergency care or get treated by an out-of-network provider at an in-network hospital or ambulatory surgical center, you are protected from surprise billing or balance billing.
What is “balance billing” (sometimes called “surprise billing”)?
When you see a doctor or other health care provider, you may owe certain out-of-pocket costs such as a copayment, coinsurance, and/or a deductible. You may also have other costs or have to pay the entire bill if you receive care from a provider that is “out-of-network” for your health plan’s network.
“Out-of-network” means the provider has not signed a contract with your health plan to provide services. Out-of-network providers may be allowed to bill you for the difference between what your plan agreed to pay and the full amount charged to the plan for a service. This is called “balance billing.” This amount may be more than in-network costs for the same service and might not count toward your annual out-of-pocket limit.
“Surprise billing” is an unexpected balance bill. This can happen when you can’t control who is involved in your care—like when you have an emergency or when you schedule a visit at an in-network facility but are unexpectedly treated by an out-of-network provider that you do not or cannot choose.
You are protected from balance billing for:
Emergency services
If you have an emergency medical condition and get emergency services from an out-of-network provider or facility, the most the provider or facility typically may bill you is your plan’s in-network cost-sharing amount (such as copayments and coinsurance). You can’t be balance billed for these emergency services. This includes services you may get at the facility caring for you after you’re in stable condition.
Certain services at an in-network hospital or ambulatory surgical center
When you get services from an in-network hospital or ambulatory surgical center, certain providers there may be out-of-network. In these cases, the most those providers may bill you is your plan’s in-network cost-sharing amount. This applies to emergency medicine, anesthesia, pathology, radiology, laboratory, neonatology, assistant surgeon, hospitalist, or intensivist services. These providers cannot bill you nor may they ask you to give up your protections against being balanced billed.
If you get certain other services at these in-network facilities, out-of-network providers can’t balance bill you, unless you give written consent and give up your protections.
Effect of Specific State Rules
Some states have their own laws relating to balance or surprise billing for out-of-network laboratory or pathology services that may be different from those described here.
- Arizona
- California
- Colorado
- Connecticut
- Delaware
- Florida
- Georgia
- Illinois
- Indiana
- Maine
- Maryland
- Massachusetts
- Michigan
- Mississippi
- Missouri
- Nebraska
- Nevada
- New Hampshire
- New Jersey
- New Mexico
- New York
- Ohio
- Oregon
- Pennsylvania
- Texas
- Virginia
- Washington
- West Virginia
You’re never required to give up your protections from balance billing. You also aren’t required to get care out-of-network. You can choose a provider or facility in your plan’s network.
When balance billing isn’t allowed, you also have these protections:
- You are only responsible for paying your share of the cost (like the copayments, coinsurance, and deductibles) that you would pay if Renalytix was an in-network provider. Your health plan will pay Renalytix directly.
- Your health plan generally must:
- Cover emergency services without requiring you to get approval for services in advance (prior authorization).
- Cover emergency services by out-of-network providers.
- Base what you owe the provider or facility (cost-sharing) on what it would pay an in-network provider or facility and show that amount in your explanation of benefits.
- Count any amount you pay for emergency services or out-of-network services toward your deductible and out-of-pocket limit.
If you think you’ve been wrongly billed: you may file a complaint with the federal government at https://www.cms.gov/nosurprises/consumers or by calling 1-800-985-3059; and/or file a complaint with your state balance billing regulator, if any, which is identified in the state-specific tabs.
Visit https://www.cms.gov/nosurprises for more information about your rights under federal law or visit your home state regulator’s website (included in state links above) for more information about your state balance billing rights.
ARIZONA RESIDENTS
ARIZONA LAW MAY PROVIDE PROTECTIONS TO YOU AND ALLOW RENALYTIX TO BILL YOU FOR AMOUNTS THAT ARE DIFFERENT FROM THOSE PROVIDED BY THE FEDERAL LAW AS DESCRIBED IN YOUR RIGHTS AND PROTECTIONS AGAINST SURPRISE MEDICAL BILLING.
FOR MORE INFORMATION REGARDING YOUR PROTECTIONS AGAINST SURPRISE BILLING, CONTACT OR VISIT:
Arizona Department of Insurance and Financial Institutions Address: 100 N. 15th Ave. Ste. 261, Phoenix, AZ 85007-2630
Phone: (602) 364-3100
E-mail: soonbdr@azinsurance.gov
Website: https://difi.az.gov/soonbdrov/
CALIFORNIA RESIDENTS
CALIFORNIA LAW MAY PROVIDE PROTECTIONS TO YOU AND ALLOW RENALYTIX TO BILL YOU FOR AMOUNTS THAT ARE DIFFERENT FROM THOSE PROVIDED BY THE FEDERAL LAW AS DESCRIBED IN YOUR RIGHTS AND PROTECTIONS AGAINST SURPRISE MEDICAL BILLING.
FOR MORE INFORMATION REGARDING YOUR PROTECTIONS AGAINST SURPRISE BILLING OR TO LEARN ABOUT MAKING A COMPLAINT CONTACT OR VISIT:
California Department of Insurance
Phone: 1-800-927-4357
Website: https://www.insurance.ca.gov/01-consumers/110-health/60-resources/NoSupriseBills.cfm or http://www.insurance.ca.gov/01-consumers/101-help/index.cfm
COLORADO RESIDENTS
COLORADO LAW MAY PROVIDE PROTECTIONS TO YOU AND ALLOW RENALYTIX TO BILL YOU FOR AMOUNTS THAT ARE DIFFERENT FROM THOSE PROVIDED BY THE FEDERAL LAW AS DESCRIBED IN YOUR RIGHTS AND PROTECTIONS AGAINST SURPRISE MEDICAL BILLING.
FOR MORE INFORMATION REGARDING YOUR PROTECTIONS AGAINST SURPRISE BILLING OR TO LEARN ABOUT MAKING A COMPLAINT CONTACT OR VISIT: Office of the Attorney General
Address: 1300 Broadway, 10th Floor, Denver, CO 80203
Telephone: (720) 508-6000
Website: https://coag.gov/file-complaint/
CONNECTICUT RESIDENTS
CONNECTICUT LAW MAY PROVIDE PROTECTIONS TO YOU AND ALLOW RENALYTIX TO BILL YOU FOR AMOUNTS THAT ARE DIFFERENT FROM THOSE PROVIDED BY THE FEDERAL LAW AS DESCRIBED IN YOUR RIGHTS AND PROTECTIONS AGAINST SURPRISE MEDICAL BILLING.
FOR MORE INFORMATION REGARDING YOUR PROTECTIONS AGAINST SURPRISE BILLING OR TO LEARN ABOUT MAKING A COMPLAINT CONTACT OR VISIT:
The State of Connecticut does not have a state balance billing enforcement program or maintain publicly available information about its balance billing laws.
DELAWARE RESIDENTS
DELAWARE LAW MAY PROVIDE PROTECTIONS TO YOU AND ALLOW RENALYTIX TO BILL YOU FOR AMOUNTS THAT ARE DIFFERENT FROM THOSE PROVIDED BY THE FEDERAL LAW AS DESCRIBED IN YOUR RIGHTS AND PROTECTIONS AGAINST SURPRISE MEDICAL BILLING.
FOR MORE INFORMATION REGARDING YOUR PROTECTIONS AGAINST SURPRISE BILLING OR TO LEARN ABOUT MAKING A COMPLAINT CONTACT OR VISIT:
Delaware Department of Insurance
Phone: 1-800-282-8611 (In Delaware Only) Or (302) 674-7310
Email: consumer@delaware.gov
Website: https://insurance.delaware.gov/services/filecomplaint/
FLORIDA RESIDENTS
FLORIDA LAW MAY PROVIDE PROTECTIONS TO YOU AND ALLOW RENALYTIX TO BILL YOU FOR AMOUNTS THAT ARE DIFFERENT FROM THOSE PROVIDED BY THE FEDERAL LAW AS DESCRIBED IN YOUR RIGHTS AND PROTECTIONS AGAINST SURPRISE MEDICAL BILLING (HYPERLINK BACK TO THE GENERAL NSA BILLING RIGHTS IN THE EVENT A FL RESIDENT LANDS HERE.).
FOR MORE INFORMATION REGARDING YOUR PROTECTIONS AGAINST SURPRISE BILLING OR TO LEARN ABOUT MAKING A COMPLAINT CONTACT OR VISIT:
Florida has not designated a surprise billing enforcement agency.
GEORGIA RESIDENTS
GEORGIA LAW MAY PROVIDE PROTECTIONS TO YOU AND ALLOW RENALYTIX TO BILL YOU FOR AMOUNTS THAT ARE DIFFERENT FROM THOSE PROVIDED BY THE FEDERAL LAW AS DESCRIBED IN YOUR RIGHTS AND PROTECTIONS AGAINST SURPRISE MEDICAL BILLING.
FOR MORE INFORMATION REGARDING YOUR PROTECTIONS AGAINST SURPRISE BILLING OR TO LEARN ABOUT MAKING A COMPLAINT CONTACT OR VISIT:
Office of Commissioner of Insurance
Address: 2 Martin Luther King Jr. Dr., West Tower, Suite 702, Atlanta, GA 30334
Telephone: (404) 656-2070
Website: https://oci.georgia.gov/
ILLINOIS RESIDENTS
ILLINOIS LAW MAY PROVIDE PROTECTIONS TO YOU AND ALLOW RENALYTIX TO BILL YOU FOR AMOUNTS THAT ARE DIFFERENT FROM THOSE PROVIDED BY THE FEDERAL LAW AS DESCRIBED IN YOUR RIGHTS AND PROTECTIONS AGAINST SURPRISE MEDICAL BILLING.
FOR MORE INFORMATION REGARDING YOUR PROTECTIONS AGAINST SURPRISE BILLING OR TO LEARN ABOUT MAKING A COMPLAINT CONTACT OR VISIT:
The Illinois Department of Insurance
Phone: (877) 527-9431
Website: https://www2.illinois.gov/sites/Insurance/consumers/Pages/default.aspx
INDIANA RESIDENTS
INDIANA LAW MAY PROVIDE PROTECTIONS TO YOU AND ALLOW RENALYTIX TO BILL YOU FOR AMOUNTS THAT ARE DIFFERENT FROM THOSE PROVIDED BY THE FEDERAL LAW AS DESCRIBED IN YOUR RIGHTS AND PROTECTIONS AGAINST SURPRISE MEDICAL BILLING.
FOR MORE INFORMATION REGARDING YOUR PROTECTIONS AGAINST SURPRISE BILLING OR TO LEARN ABOUT MAKING A COMPLAINT CONTACT OR VISIT:
Indiana Department of Insurance, Consumer Service Department
Address: 311 West Washington Street, Suite 300, Indianapolis, IN 46204-2787
Telephone: 1-800-622-4461
Email: consumerservices@idoi.in.gov
Websites: https://content.govdelivery.com/accounts/INDOI/bulletins/29ac870 OR https://www.in.gov/idoi/consumer-services/
MAINE RESIDENTS
MAINE LAW MAY PROVIDE PROTECTIONS TO YOU AND ALLOW RENALYTIX TO BILL YOU FOR AMOUNTS THAT ARE DIFFERENT FROM THOSE PROVIDED BY THE FEDERAL LAW AS DESCRIBED IN YOUR RIGHTS AND PROTECTIONS AGAINST SURPRISE MEDICAL BILLING.
FOR MORE INFORMATION REGARDING YOUR PROTECTIONS AGAINST SURPRISE BILLING OR TO LEARN ABOUT MAKING A COMPLAINT CONTACT OR VISIT:
Maine Bureau of Insurance
Address: 34 State House Station, Augusta, ME 04333
Telephone: 207-624-8475
Email: insurance.pfr@maine.gov
Website: https://www.maine.gov/pfr/insurance/
MARYLAND RESIDENTS
MARYLAND LAW MAY PROVIDE PROTECTIONS TO YOU AND ALLOW RENALYTIX TO BILL YOU FOR AMOUNTS THAT ARE DIFFERENT FROM THOSE PROVIDED BY THE FEDERAL LAW AS DESCRIBED IN YOUR RIGHTS AND PROTECTIONS AGAINST SURPRISE MEDICAL BILLING.
FOR MORE INFORMATION REGARDING YOUR PROTECTIONS AGAINST SURPRISE BILLING OR TO LEARN ABOUT MAKING A COMPLAINT CONTACT OR VISIT:
The Maryland Insurance Administration
Address: 200 St. Paul Place, Suite 2700, Baltimore, Maryland 21202
Telephone: 410-468-2000
E-mail: insurance.mia@maryland.gov
Websites: www.insurance.maryland.gov or https://insurance.maryland.gov/Consumer/Documents/publications/AssignmentofBenefitsFAQ.pdf
MASSACHUSETTS RESIDENTS
MASSACHUSETTS LAW MAY PROVIDE PROTECTIONS TO YOU AND ALLOW RENALYTIX TO BILL YOU FOR AMOUNTS THAT ARE DIFFERENT FROM THOSE PROVIDED BY THE FEDERAL LAW AS DESCRIBED IN YOUR RIGHTS AND PROTECTIONS AGAINST SURPRISE MEDICAL BILLING.
FOR MORE INFORMATION REGARDING YOUR PROTECTIONS AGAINST SURPRISE BILLING OR TO LEARN ABOUT MAKING A COMPLAINT CONTACT OR VISIT:
Health and Human Services of the Commonwealth of Massachusetts
Address: 1 Ashburton Place, 11th Floor Boston, Massachusetts 02108
Telephone: (617) 573-1600
Email: marylou.sudders@state.ma.us
MICHIGAN RESIDENTS
MICHIGAN LAW MAY PROVIDE PROTECTIONS TO YOU AND ALLOW RENALYTIX TO BILL YOU FOR AMOUNTS THAT ARE DIFFERENT FROM THOSE PROVIDED BY THE FEDERAL LAW AS DESCRIBED IN YOUR RIGHTS AND PROTECTIONS AGAINST SURPRISE MEDICAL BILLING.
FOR MORE INFORMATION REGARDING YOUR PROTECTIONS AGAINST SURPRISE BILLING OR TO LEARN ABOUT MAKING A COMPLAINT CONTACT OR VISIT:
Michigan Department of Insurance and Financial Services
Hotline: 877-999-6442
Websites: https://www.michigan.gov/difs/0,5269,7-303-13222_13250-561696–,00.html or https://www.michigan.gov/DIFScomplaints
MISSISSIPPI RESIDENTS
MISSISSIPPI LAW MAY PROVIDE PROTECTIONS TO YOU AND ALLOW RENALYTIX TO BILL YOU FOR AMOUNTS THAT ARE DIFFERENT FROM THOSE PROVIDED BY THE FEDERAL LAW AS DESCRIBED IN YOUR RIGHTS AND PROTECTIONS AGAINST SURPRISE MEDICAL BILLING.
FOR MORE INFORMATION REGARDING YOUR PROTECTIONS AGAINST SURPRISE BILLING OR TO LEARN ABOUT MAKING A COMPLAINT CONTACT OR VISIT:
Mississippi Insurance Department, Office of the Insurance Commissioner
Address: Mississippi Insurance Department, P.O. Box 79, Jackson, MS 39205
Telephone: 601-359-3569
Email: mike.chaney@mid.ms.gov
Website: http://www.mid.ms.gov or http://www.mid.ms.gov/healthcare/questionsanswers/TopicTwo.pdf
MISSOURI RESIDENTS
MISSOURI LAW MAY PROVIDE PROTECTIONS TO YOU AND ALLOW RENALYTIX TO BILL YOU FOR AMOUNTS THAT ARE DIFFERENT FROM THOSE PROVIDED BY THE FEDERAL LAW AS DESCRIBED IN YOUR RIGHTS AND PROTECTIONS AGAINST SURPRISE MEDICAL BILLING.
FOR MORE INFORMATION REGARDING YOUR PROTECTIONS AGAINST SURPRISE BILLING OR TO LEARN ABOUT MAKING A COMPLAINT CONTACT OR VISIT:
Missouri Department of Insurance Address: PO Box 690, Jefferson City, MO 65102-0690
Telephone: (573) 751-4126
Email: news@difp.mo.gov
website: https://insurance.mo.gov/consumers/health/managingcost.php
NEBRASKA RESIDENTS
NEBRASKA LAW MAY PROVIDE PROTECTIONS TO YOU AND ALLOW RENALYTIX TO BILL YOU FOR AMOUNTS THAT ARE DIFFERENT FROM THOSE PROVIDED BY THE FEDERAL LAW AS DESCRIBED IN YOUR RIGHTS AND PROTECTIONS AGAINST SURPRISE MEDICAL BILLING.
FOR MORE INFORMATION REGARDING YOUR PROTECTIONS AGAINST SURPRISE BILLING OR TO LEARN ABOUT MAKING A COMPLAINT CONTACT OR VISIT:
Nebraska Department of Insurance
Phone: 402-471-2201 or call our toll-free consumer hotline at 1-877-564-7323.
Additional information is available on our website at.
Websites: www.doi.nebraska.gov or https://doi.nebraska.gov/sites/doi.nebraska.gov/files/doc/ConsumerFactSheetBalanceBillingandOutofNetworkProviders.pdf or https://doi.nebraska.gov/consumer/consumer-assistance
NEVADA RESIDENTS
NEVADA LAW MAY PROVIDE PROTECTIONS TO YOU AND ALLOW RENALYTIX TO BILL YOU FOR AMOUNTS THAT ARE DIFFERENT FROM THOSE PROVIDED BY THE FEDERAL LAW AS DESCRIBED IN YOUR RIGHTS AND PROTECTIONS AGAINST SURPRISE MEDICAL BILLING.
FOR MORE INFORMATION REGARDING YOUR PROTECTIONS AGAINST SURPRISE BILLING OR TO LEARN ABOUT MAKING A COMPLAINT CONTACT OR VISIT:
Nevada Department of Insurance Consumer Compliance & Licensing 1818 E. College Pkwy., Suite 103 Carson City, NV 89706
Phone: (775) 687-0700
Website: https://doi.nv.gov/Consumers/Health_and_Accident_Insurance/Balance_Billing_FAQs/
NEW HAMPSHIRE RESIDENTS
NEW HAMPSHIRE LAW MAY PROVIDE PROTECTIONS TO YOU AND ALLOW RENALYTIX TO BILL YOU FOR AMOUNTS THAT ARE DIFFERENT FROM THOSE PROVIDED BY THE FEDERAL LAW AS DESCRIBED IN YOUR RIGHTS AND PROTECTIONS AGAINST SURPRISE MEDICAL BILLING.
FOR MORE INFORMATION REGARDING YOUR PROTECTIONS AGAINST SURPRISE BILLING OR TO LEARN ABOUT MAKING A COMPLAINT CONTACT OR VISIT:
New Hampshire Insurance Department
Address: 21 South Fruit Street, Suite 14, Concord, NH 03301
Telephone: 1 (800) 852-3416
Email: consumerservices@ins.nh.gov
Websites: https://www.nh.gov/insurance/consumers/ or https://www.nh.gov/insurance/consumers/documents/20211210-nsa-faq-consumers-producers.pdf
NEW JERSEY RESIDENTS
NEW JERSEY LAW MAY PROVIDE PROTECTIONS TO YOU AND ALLOW RENALYTIX TO BILL YOU FOR AMOUNTS THAT ARE DIFFERENT FROM THOSE PROVIDED BY THE FEDERAL LAW AS DESCRIBED IN YOUR RIGHTS AND PROTECTIONS AGAINST SURPRISE MEDICAL BILLING.
FOR MORE INFORMATION REGARDING YOUR PROTECTIONS AGAINST SURPRISE BILLING OR TO LEARN ABOUT MAKING A COMPLAINT CONTACT OR VISIT:
New Jersey Department of Banking and Insurance
Address: State of 20 West State Street P.O. Box 325 Trenton, New Jersey 08625-0325
Telephone: (609) 292-7272
Email: marlene.caride@dobi.nj.gov
website: https://www.state.nj.us/dobi/division_consumers/insurance/outofnetwork.html
NEW MEXICO RESIDENTS
NEW MEXICO LAW MAY PROVIDE PROTECTIONS TO YOU AND ALLOW RENALYTIX TO BILL YOU FOR AMOUNTS THAT ARE DIFFERENT FROM THOSE PROVIDED BY THE FEDERAL LAW AS DESCRIBED IN YOUR RIGHTS AND PROTECTIONS AGAINST SURPRISE MEDICAL BILLING.
FOR MORE INFORMATION REGARDING YOUR PROTECTIONS AGAINST SURPRISE BILLING OR TO LEARN ABOUT MAKING A COMPLAINT CONTACT OR VISIT:
New Mexico Licensing and Regulation Department
Address: PO Box 25101, Santa Fe, NM 87504
Telephone: (505) 469-0982
Email: linda.trujillo@nmlegis.gov
Website: https://www.osi.state.nm.us/
NEW YORK RESIDENTS
For patients in New York, if your insurance ID card says, “fully insured coverage,” surprise bills include when you’re in-network doctor refers you to an out-of-network provider without your consent (including lab and pathology services). These providers can’t balance bill you and may not ask you to give up your protections not to be balance billed. You may need to sign a form (available on the Department of Financial Services’ website) for the full balance billing protection to apply.
These rights and protections are different from those described in YOUR RIGHTS AND PROTECTIONS AGAINST SURPRISE MEDICAL BILLING
FOR MORE INFORMATION REGARDING YOUR PROTECTIONS AGAINST SURPRISE BILLING OR TO LEARN ABOUT MAKING A COMPLAINT CONTACT OR VISIT:
New York State Department of Financial Services
Address: 1 State Street, New York, NY 10004-1511
Telephone: (800) 342-3736
E-mail: consumers@dfs.ny.gov
Websites: http://www.dfs.ny.gov or Surprisemedicalbills@dfs.ny.gov
OHIO RESIDENTS
OHIO LAW MAY PROVIDE PROTECTIONS TO YOU AND ALLOW RENALYTIX TO BILL YOU FOR AMOUNTS THAT ARE DIFFERENT FROM THOSE PROVIDED BY THE FEDERAL LAW AS DESCRIBED IN YOUR RIGHTS AND PROTECTIONS AGAINST SURPRISE MEDICAL BILLING.
FOR MORE INFORMATION REGARDING YOUR PROTECTIONS AGAINST SURPRISE BILLING OR TO LEARN ABOUT MAKING A COMPLAINT CONTACT OR VISIT:
Ohio Department of Insurance 50 W Town Street Suite 300, Columbus Ohio 43215
Phone: 800-686-1526
website: https://insurance.ohio.gov/wps/portal/gov/odi/consumers/health/surprise-billing
OREGON RESIDENTS
OREGON LAW MAY PROVIDE PROTECTIONS TO YOU AND ALLOW RENALYTIX TO BILL YOU FOR AMOUNTS THAT ARE DIFFERENT FROM THOSE PROVIDED BY THE FEDERAL LAW AS DESCRIBED IN YOUR RIGHTS AND PROTECTIONS AGAINST SURPRISE MEDICAL BILLING.
FOR MORE INFORMATION REGARDING YOUR PROTECTIONS AGAINST SURPRISE BILLING OR TO LEARN ABOUT MAKING A COMPLAINT CONTACT OR VISIT:
Department of Consumer and Business Services, Division of Financial Regulation
Address: P.O. Box 14480, Salem, OR 97309-0405
Telephone: 888-877-4894
Website: https://www.oregon.gov/dcbs/pages/index.aspx
PENNSYLVANIA RESIDENTS
PENNSYLVANIA LAW MAY PROVIDE PROTECTIONS TO YOU AND ALLOW RENALYTIX TO BILL YOU FOR AMOUNTS THAT ARE DIFFERENT FROM THOSE PROVIDED BY THE FEDERAL LAW AS DESCRIBED IN YOUR RIGHTS AND PROTECTIONS AGAINST SURPRISE MEDICAL BILLING. FOR MORE INFORMATION REGARDING YOUR PROTECTIONS AGAINST SURPRISE BILLING OR TO LEARN ABOUT MAKING A COMPLAINT CONTACT OR VISIT:
Pennsylvania Department of Insurance
Address: 1326 Strawberry Square, Harrisburg, PA 17120
Telephone: (717) 787-0872
Website: https://expressforms.pa.gov/apps/pa/insurance/contact-us or https://pennpirg.org/sites/pirg/files/resources/PennPIRG%20Surprise%20Billing%20tip%20sheet_formatted.docx_.pdf
TEXAS RESIDENTS
TEXAS LAW MAY PROVIDE PROTECTIONS TO YOU AND ALLOW RENALYTIX TO BILL YOU FOR AMOUNTS THAT ARE DIFFERENT FROM THOSE PROVIDED BY THE FEDERAL LAW AS DESCRIBED IN YOUR RIGHTS AND PROTECTIONS AGAINST SURPRISE MEDICAL BILLING.
FOR MORE INFORMATION REGARDING YOUR PROTECTIONS AGAINST SURPRISE BILLING OR TO LEARN ABOUT MAKING A COMPLAINT CONTACT OR VISIT:
Texas Department of Insurance
Phone: 800-252-3439
Website: https://www.tdi.texas.gov/tips/texas-protects-consumers-from-surprise-medical-bills.html
VIRGINIA RESIDENTS
Consumers covered under (i) fully-insured policies issued in Virginia, (ii) the Virginia state employee health benefit plan; or (ii) as self-funded group or plan that opted into the Virginia protections area also protected from balance billing under Virginia law. These protections may be different from the ones provided by the federal law as described in YOUR RIGHTS AND PROTECTIONS AGAINST SURPRISE MEDICAL BILLING.
FOR MORE INFORMATION REGARDING YOUR PROTECTIONS AGAINST SURPRISE BILLING OR TO LEARN ABOUT MAKING A COMPLAINT CONTACT OR VISIT: The State Corporation Commission Bureau of Insurance
Address: Bureau of Insurance – SCC, P.O. Box 1157, Richmond, Virginia 23218
Telephone: 877-310-6560
Email: bureauofinsurance@scc.virginia.gov
Websites: https://scc.virginia.gov/pages/Balance-Billing-Protection; Scc.virginia.gov/pages/File-Complaint-Consumers
WASHINGTON RESIDENTS
WASHINGTON LAW MAY PROVIDE PROTECTIONS TO YOU AND ALLOW RENALYTIX TO BILL YOU FOR AMOUNTS THAT ARE DIFFERENT FROM THOSE PROVIDED BY THE FEDERAL LAW AS DESCRIBED IN YOUR RIGHTS AND PROTECTIONS AGAINST SURPRISE MEDICAL BILLING.
FOR MORE INFORMATION REGARDING YOUR PROTECTIONS AGAINST SURPRISE BILLING OR TO LEARN ABOUT MAKING A COMPLAINT CONTACT OR VISIT:
Washington Office of the Insurance Commissioner
Phone: 800-562-6900
Websites: https://www.insurance.wa.gov/file-complaint-or-check-your-complaint-status or https://www.insurance.wa.gov/what-consumers-need-know-about-surprise-or-balance-billing
WEST VIRGINIA RESIDENTS
WEST VIRGINIA LAW MAY PROVIDE PROTECTIONS TO YOU AND ALLOW RENALYTIX TO BILL YOU FOR AMOUNTS THAT ARE DIFFERENT FROM THOSE PROVIDED BY THE FEDERAL LAW AS DESCRIBED IN YOUR RIGHTS AND PROTECTIONS AGAINST SURPRISE MEDICAL BILLING.
FOR MORE INFORMATION REGARDING YOUR PROTECTIONS AGAINST SURPRISE BILLING OR TO LEARN ABOUT MAKING A COMPLAINT CONTACT OR VISIT:
Offices of Insurance Commissioner
Address: West Virginia Offices of the Insurance Commissioner P.O. Box 50540 Charleston, West Virginia 25305-0540
Telephone: (304) 558-3354
Email: jim@jimdodrill.com
Website: https://www.wvinsurance
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Claim Filing
Renalytix will file a claim with your insurance company once the kidneyintelX.dkd test has been processed. Insurance typically responds in less than two months with a coverage decision.*
* If the claim is processed by insurance, most patient statements will be sent within 60 days from the date of service. If the claim has undergone the appeal process, it may take 6 months or longer to receive a patient statement outlining the patient responsibility. This statement will be followed by a bill for any amount owed to Renalytix, which must be paid – or a payment plan must be established – within 30 days.
Coverage Decision & Appeals
Renalytix will work on your behalf to ensure that you get the best coverage benefit. When applicable, Renalytix will appeal the denial with your insurance. The insurance company will review the appeal to make a coverage (or denial) determination.
During this time, you may receive several Explanation of Benefits (EOB) statements. An EOB is provided to you as a summary of your medical expenses and how claims were processed by your insurance company. An EOB will outline any cost-sharing amounts (co-insurance, deductible, or patient balance) that would be your responsibility.
Your Statement
After the claims process is complete, or when the appeals process has reached a decision*, you will receive a statement for any outstanding cost-sharing amounts (for example, co-payment, co-insurance, deductibles) that remain your responsibility.
*Even after a coverage decision has been made by a patient’s insurance company, the patient may be eligible to pay a reduced cost if they qualify for our Patient Assistance Program (PAP).
We take your privacy, very seriously.
Renalytix is 100% committed to protecting your privacy. Please review our Privacy and HIPAA practices and contact our Patient Support Team with any questions.
Patient Support Team
888-203-2725
patientsupport@renalytix.com
Privacy & HIPAA Practices
How is a bill different from an EOB or Explanation of Benefits?
You may get other notices about this test from your insurance company. These will look different from the example bill. That’s because, every time a claim is sent to your insurance for services which you have had, they are required to provide a statement telling you their decision on the claim. These are usually called an “Explanation of Benefits” or “EOB”. Some insurance plans might use a different term. If you have more than one insurance plan, you might receive notices from both plans.
Prior authorizations or claim appeals are sometimes needed. If so, you might receive letters from your insurance company for these. Examples of EOBs or other letters can often be found on your insurance plan’s website.
As always, we are here to help you with any questions you may have regarding your bill or other letters or notices you receive. Please contact us, and we will help you get the answers you need.
After your insurance has made a decision on your claim, they will send payment to Renalytix for any amount that they are paying on your claim. They will also send us a notice which tells us if you owe anything for the test and how much you owe. We review this notice before you are billed so that we can correct any issues with your claim. We will only send you a bill once we determine that you have a balance with us. Our bill will look like the example bill provided here, but it will have your information.
