Pathwork Diagnostics

Reimbursement and billing assistance

The Pathwork Tissue of Origin Test is the only FDA-cleared and Medicare-covered molecular diagnostic test for tissue of origin. Through the Pathwork Reimbursement Assistance Program (RAP), the company provides support to physicians, their institutions, and their patients throughout the benefits investigation and billing process.

Pathwork Diagnostics is prepared to take formal assignment of benefits whenever possible and submit insurance claims for the Tissue of Origin Test on behalf of insured patients in the U.S. We do not expect institutions or healthcare providers to order this test from Pathwork Diagnostics and then bill third-party payers on their own, except where required to comply with billing regulations or policies, or pre-existing contractual arrangements.

The Pathwork RAP may perform benefits investigations to provide patients with information about their specific coverage and potential financial responsibility. If authorization by an insurer is required prior to the processing of the patient's specimen, the Pathwork RAP team can help facilitate this process. If coverage is denied, Pathwork will appeal this denial on behalf of the patient and pursue the claim until all levels of appeals are exhausted. The Pathwork RAP provides assistance for patients with financial hardship and for those patients who are uninsured and underinsured.

We are committed to expanding private insurance coverage for the Pathwork Tissue of Origin Test and will continue to work with all major plans across the United States.