Today we’re proud to release a video that’s been in development for a long time. Our goal was to explain in simple terms how Foundation Medicine makes their genomic test affordable to all. The video will be used to help FM’s patient service and sales teams save tons of time explaining the billing, insurance reimbursement, and financial assistance processes.
For greater context, check out Foundation Medicine’s fantastic landing page that explains the patient cancer journey.
At Foundation Medicine, we understand that when you or a loved one is battling cancer, confusing documents and financial burden are the last things you want to worry about.
That’s why we created the Foundation ACCESS program, which offers direct support and guidance during each step of the billing process.
When your doctor recommends one of our tests, you may have questions about cost and what your out-of-pocket expense may be. Foundation Medicine is currently an out-of-network provider for many insurers, which means your test may not be automatically covered by your insurance.
The Foundation ACCESS program is here to help with these issues and more. To get started, complete and submit the financial assistance application available at mycancerisunique.com. This simple form requests your basic financial information.
Once submitted, we’ll respond to your application within two business days, estimating your maximum financial obligation only in the event that your test is not covered by insurance. The amount of this estimate may be different from your final bill.
With a clearer picture of your financial obligations, you can choose to move forward with the test. Inform your doctor that you’re ready, and when the test results are delivered, we’ll send you a letter notifying you that we have billed your insurance.
Next, your insurer may send you an explanation of benefits, or EOB, that estimates your coverage for the test. This letter is not a bill and it is not a final decision about your coverage.
Your insurance company may deny all or part of the test fee. However, Foundation Medicine will promptly appeal this coverage decision for you. In some cases, we may send you a form that requests your consent to appeal on your behalf. To get the best coverage for you, it’s vital that you complete and submit this form as soon as you can. Don’t hesitate to contact us if you need help filling it out.
The last step is your final bill. You will only receive a bill from us once we’ve completed all appeals to your insurer. The amount due may simply be your insurance co-payment or deductible, which would be required for any provider–such as your hospital or physician–to charge for any procedure. Based on your ACCESS Application, we may offer a need-based discount, an affordable payment plan, or both to assist with your out-of-pocket costs. Your bill will reflect your final responsibility, less any discounts applied based on your financial situation.
Keep in mind that you can request financial assistance at any time before or after your test is complete. And even if you haven’t submitted a financial assistance application, we may reach out during the billing process to request one from you if we feel it may be helpful to you. We work with every patient within their ability to pay.
In this trying time, we want to make the billing process as simple as possible, all while ensuring our test is affordable to you. Have questions or concerns? Don’t hesitate to contact us. We’re here to help every step of the way.