ComplaintsforGenedx Inc

• Initial Complaint

  02/15/2023

  Complaint Type:

  Product Issues

  Status:

  Resolved

  More info

  ************************* from ****** Medical ordered 2 GeneDx genetic tests for me during my appointment with her on 2/9/22. For some reason, GeneDx billed my insurance shortly thereafter (Feb. 14/15th) despite the following: my test kit had not been sent to them yet, a preauthorization was not completed as required by my insurance, and no authorization was given by me for the tests to be completed. I received a call from a GeneDx representative at the end of March (3/31/22) letting me know that they checked my insurance for both tests and the only financial responsibility I would have is $530. I asked the total costs of the tests and he told me $1500. He asked if based on that information if I would approve moving forward with the tests and I said yes. I called GeneDx on 10/7/22 inquiring about the $530 bill. I was told by a representative incorrect information that I completed a test in November and that my insurance didn't cover it. I contacted Genome Medical and spoke with ****** about my situation with GeneDx since they referred me. ****** reached out to a GeneDx supervisor and cleared up that my test was ordered in February 2022, not November 2022, and she got a copy of the Benefits Investigation that was completed for me. ****** was also told my max responsibility would be $530 and she sent me a copy of the Benefits Investigation that stated that. Now Feb. 2023 and no word from GeneDx, I contacted ****** ********** and ***** Claims on 2/2/23, representatives in both departments told me that GeneDx did not complete a preauthorization as is required by my insurance to have the tests covered and that I was not responsible for the balance as a result. They told me to confirm a zero balance with GeneDx as the insurance informed them of this, and if I couldnt confirm this, to call back and file an appeal. I keep trying to reach a supervisor to confirm this zero balance. If I dont hear from someone soon, I will be filing an appeal and contacting Consumer Affairs.

  Business response

  03/14/2023

  Dear BBB representatives, 

  We received your letter regarding the above complaint dated February 26, 2023. We thank **** ***** for  bringing this matter to our attention, and regret that she did not have a satisfactory customer experience. When the patient initially contacted our billing representative, the patient was mis-informed regarding her  out of pocket cost and the benefit investigation process. Just a few days before receiving this formal  complaint, we were notified by the healthcare team coordinating her testing that the patient was concerned  about cost at which point our Billing Senior Manager contacted the patient, reviewed the billing  investigation process and the actual estimated cost. The billing representative who provided  misinformation is undergoing retraining. We also followed up with the office of the provider coordinating  testing to apologize for the miscommunication and gave an update. 

  Since that time, the claim has been processed and was denied due to lack of prior authorization.  Accordingly, the patient responsibility was adjusted, the patient was contacted by our Billing Senior  Manager with this update and accepted the resolution. We ask you to consider this complaint to be fully resolved. 
  

  Please let us know if you any further questions. 
  

  Sincerely, 
  
  Gabriele R******, MD, FACMG 
  Medical Director 

  Customer response

  03/21/2023

  [A default letter is provided here which indicates your acceptance of the business's response.  If you wish, you may update it before sending it.]
  
  Better Business Bureau:
  
  I have reviewed the response made by the business in reference to complaint ID ********, and find that this resolution is satisfactory to me. I do greatly appreciate GeneDxs professional response and resolving the matter with me. I do have some additional comments I want to include here: The original claim for my genetic tests was not just processed but was denied over a year ago due to a lack of prior authorization and the additional claims submitted since were seen as duplicates and also denied. Per Optum, a retro preauthorization could have been submitted to correct the issue but was not done. I had been trying to contact a supervisor since October 2022 and don't feel that it should take filing complaints to get a response from one. As far as your representative who gave misinformation to me, no amount of retraining could help her attitude and level of professionalism. She told me that GeneDx had no obligation to bill people’s insurances correctly and was extremely rude each time I spoke to her. She also would never allow me to speak to a supervisor. She obviously dislikes her job and should not be in customer service. 

  
  Regards,
  
  ***************************
  

• Initial Complaint

  01/24/2023

  Complaint Type:

  Sales and Advertising Issues

  Status:

  Resolved

  More info

  I had genetic testing done. I was invoiced & paid in Sept 30, 2022. Statement # ****** accession # ******* $900. Other invoice #****** accession #******* for $325. Total of $1225.00 paid 9/30/22. Then billed again I paid several smaller payments & then $1075. Same accession #s. I think I have paid this twice. Please advise

• Initial Complaint

  08/24/2022

  Complaint Type:

  Order Issues

  Status:

  Answered

  More info

  GeneDX was completing gene testing on my daughter. They asked for gene samples from both parents. When the gene kit was returned to GeneDX the insurance information was provided for each of us. GeneDX sent a bill stating we owed full amount because Dr submitted as self pay in error on order. They refuse to submit to insurance and demand full self pay price, even though they submitted daughters to insurance and they have insurance information on myself as I am the primary on the medical plan. They never called to say they have conflicting information, since we submitted the insurance information and doctor stated self pay in error. They refuse to submit to insurance even though the paperwork had it included. I have contacted them on 8/10, 8/11 and 8/24 asking to process with insurance and they won't. I want others to be aware as genetic testing can be expensive and their refusal to submit to insurance, if doctor makes error on order, is unacceptable!

  Business response

  09/21/2022

  Dear BBB representatives, 
  We received your letter regarding the above complaint dated 8/31/2022. We thank *** ********* for  bringing this matter to our attention, and regret that he did not have a satisfactory customer experience. When the patient’s provider marked the testing as self-pay and we were notified of the error, it was beyond  the time window at which we could submit a prior authorization (which is a requirement of the patient’s  insurance). This was the reason why we initially denied switching testing to insurance bill, with the goal of  having the patient submit the claim separately. In the meantime, we have since spoken with the patient and  have made an exception to our billing policy, submitting the claim to his insurance. We ask you to consider  this complaint to be fully resolved. 
  

  Please let us know if you any further questions. 
  

  Sincerely, 
  
  Gabriele R******, MD, FACMG 
  Medical Director 

• Initial Complaint

  03/19/2022

  Complaint Type:

  Sales and Advertising Issues

  Status:

  Answered

  More info

  I had genetic testing completed last year 2021 and agreed to cover 100% of the charges that my insurance did not cover. Just recently, in february, I received a notice that I had been sent to collections for the payments and I had not received any bill for this. When I called GeneDX they said they would take me out of collections and I paid them the full amounts. I just now received notice that I am still in collections even though I had paid GeneDX and been told I was removed from collections. The notice on the new collections letter is dated after my receipts for payment.

  Business response

  04/13/2022

  ---------- Forwarded message ---------
  From: Gabriele R****** <********@genedx.com>
  Date: Tue, Apr 12, 2022 at 5:36 PM
  Subject: FW: BBB ********
  To: Dispute Resolution Team <[email protected]>
  

  
  

  Dear BBB Representatives,

   

  In response to your letter from 3/21/2022, please find attached our reply. Please kindly acknowledge the receipt of our response, and do not hesitate to contact me if you have further questions.

   

  Sincerely,

  Gabi

  ________________________

   

  Gabriele R*******, MD, FACMG

  Medical Director

  Mobile: ************ | ***********************************

  207 Perry Parkway, Gaithersburg, MD 20877

  GeneDx.com

• Initial Complaint

  02/11/2022

  Complaint Type:

  Service or Repair Issues

  Status:

  Resolved

  More info

  A buccal swab was mailed to my address Feb 2021. It was agreed upon at this time on the cost and that I would be billed within the calendar year so I could use my FSA account. All my paperwork was correct however the company changed my address. They sent medical information and bills to the wrong address despite having the correct mailing address and mailing something correctly prior. I got a call on 1-28-22 that the account was sent to collection and was notified of the HIPAA violation. I attempted to get someone to contact me however a week went by and no one had. The only contact information I had for someone blocked my emails so I reached out to the doctor's office that sent us to this lab and they provided another contact who also blocked me after 1 email to her. I contacted them by phone on 2-3-22 and was told I would hear back shortly. On 2-10-22 I contacted again and was told I would have someone in contact with me by end of day. As of 2-11-20 the business continues to not provide resolution to the financial issue they created and the federal violation they have done.

  Business response

  03/07/2022

  Dear BBB representatives, 

  
  We received your letter regarding the above complaint dated 2/23/2022. We thank *** ******* for  bringing this matter to our attention, and regret that the ******* family did not have a satisfactory  customer experience. Communication with the ******* family did not meet the high standards we thrive  for and our clients expect from us. On February 21st, before we were notified of the BBB complaint, a  GeneDx representative contacted *** ******* to address her concerns, offer our apologies and a resolution  to the billing-related issues, which have been accepted in full by the ******* family. Therefore, we ask you  to consider this complaint to be fully resolved. 
  

   

  Please let us know if you any further questions. 
  

   

  Sincerely, 
  
  Gabriele R******, MD, FACMG 
  Medical Director 
  

  Customer response

  03/07/2022

  [A default letter is provided here which indicates your acceptance of the business's response.  If you wish, you may update it before sending it.]
  
  Better Business Bureau:
  
  I have reviewed the response made by the business in reference to complaint ID ********, and find that this resolution is satisfactory to me. 
  
  Regards,
  
  ***************************
  

• Initial Complaint

  10/25/2021

  Complaint Type:

  Service or Repair Issues

  Status:

  Answered

  More info

  My Son ******* ***** sees ************************* at ****** ***** for his Autism. At a appointment *** suggested we look into genetic testing. She handed me a kit for Gene dx and said go ahead and send it in and wait for a call about the price. That during that call if it was too much I could deny it. Well months later I get a call and it was too much. I denied. ****** ***** also called then and told them not to run it. Months later I get a call about results. I wonder why I am getting them. Gene Dx ran a test without consent and now trying to stick me with the bill. Also billing my 7 year old Autistic son. ****** ***** and I have fought this for over a year. I filed an appeal with *** and was denied but they told me to file a complaint here. I'm very upset my family was taken advantage of and worry for others. This is not right to do to any family but really a family with a special needs child. Thank you for reading this.

  Business response

  12/27/2021

  Novermber 16, 2021

  Dear BBB representatives, 
  We received your letter regarding the above complaint dated 10/29/21. We thank *** ***** for bringing this matter to our attention, and regret that the ***** family did not have a satisfactory customer experience. Communication with the ***** family did not meet the high standards we thrive for and our clients expect from us. On 11/16/21, a GeneDx representative has contacted the *** ***** to inform her about the results of our investigation and offered our apologies and a resolution of the testing-related issues, which have been accepted in full by the *** *****. Therefore, we ask you to consider this complaint to be fully resolved. 
  

  Please let us know if you any further questions. 
  

  Sincerely, 
  
  Gabriele R******, MD, FACMG Medical Director GeneDx 
  

• Initial Complaint

  09/01/2021

  Complaint Type:

  Product Issues

  Status:

  Answered

  More info

  My daughter's physician ordered a test through GeneDx and we were told that insurance would be covering this test at 100% with no patient responsibility. We were told that if there were going to be any patient responsibility over $100 we would be notified prior to decide if we would like to proceed. We are now receiving a bill for over $6000 (after insurance paid almost $12000 for this test). I have reached out to the company multiple times to resolve this and they are not responding to me and telling me that they will "escalate my concerns to management and I should hear back in 24-48 hours but they never call and will not allow me to speak to a manager when i call. I have called at least 5 times since 8/4 and continue to receive bills for over $6000. Due to their company policy that if there is a patient responsibility over $100 they will communicate with you prior to completing the test, the most we should owe is $100.

  Business response

  10/11/2021

  October 8, 2021

  Dear BBB representatives, 
  

  We received your letter regarding the above complaint dated September 1, 2021. We thank **** ***** for  bringing this matter to our attention, and regret that the ***** family did not have a satisfactory customer  experience. Communication with **** ***** did not meet the high standards we thrive for and our clients  expect from us. On September 15, 2021, a GeneDx representative has contacted **** ***** to informed her  about the results of our investigation and offered our apologies and a resolution of the billing-related issues,  which have been accepted in full by **** *****. Therefore, we ask you to consider this complaint to be fully  resolved. 
  

  Please let us know if you any further questions. 
  

  Sincerely, 
  
  Gabriele R.,   MD, FACMG

  Medical Director 
  GeneDx
  

*Some consumers may elect to not publish the details of their complaints, some complaints may not meet BBB's standards for publication, or BBB may display a portion of complaints when a high volume is received for a particular business. ↩