Billing & Payments

Billing & Payments

COVID-19 Cash Price

In accordance with the Coronavirus Aid, Relief, and Economic Security Act, (CARES Act) Section 3202 the cash price for high-throughput COVID-19 diagnostic laboratory testing is $100 per test.

Notice of Compliance

MPLN adheres to the guidelines set forth by CMS and Commercial insurance plans. Please see our Notice of Compliance below for additional information regarding payer requirements and client billing of testing.

Notice of Compliance
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Online Payments

Use the form below to make an online payment with a credit card or PayPal account.
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Palmetto GBA awarded MAC contract / Z-codes

Medicare Administrative Contractor (MAC) change effective February 26, 2018.

Palmetto, GBA has been awarded the MAC contract for Tennessee, Alabama and Georgia. Palmetto, GBA has additional requirements that our current MAC does not have. Once such requirement is Palmetto, GBA established a Molecular Diagnostics (MolDx) program that requires Medicare claims have Z-codes for molecular tests prior to claims submission.
Code Category/Description 2018 MolDX CPT Code Range
Tier I 81161-81383
Tier 2 81400-81408
Genomic Sequencing Procedures 81410-81471
Molecular Multianalyte Assays (MAAA) 81490-81595
MAAA Admin Codes All Codes
Immunology 86152-86153
Microbiology 87505-87507, 87631-87633, 87149-87150
PLA All Codes
Cytology 88120-88121
Not otherwise classified (NOC) 81479, 81599, 84999, 85999, 86849, 87999, 88199, 88299, 88399, 89398

To access the Z-codes for our tests, each hospital or laboratory organization must register with the DEX Diagnostics Exchange. The website to register in the Diagnostics Exchange is https://app.dexzcodes.com. To complete registration, you will need your NPI and CLIA #s. The instructions for submitting a sharing request are outlined below:

How to make a sharing request

  1. Select “Labs & Manufacturers.”
  2. Search for “Molecular Pathology Laboratory Network, Inc.”
    • Click on the lab name link, or
    • Select the “+” sign to expand a parent organization’s individual facilities, and then find the facility you send the specimen to for processing (or testing).
  3. Select the “Request Sharing” button at the top right corner.
  4. Once Molecular Pathology Laboratory Network, Inc. “approves” your sharing request, you will have access to all of the Z-Codes for the testing we perform, and you bill.
  5. Search the Lab Test Catalog by using the lab test code or name. Click on the test to see the Z-Code that will be added to your billing claim.

Medicare, Medicaid & ABN

Medical necessity guidelines are provided by Centers for Medicare & Medicaid (CMS). MPLN encourages clients to utilize an Advanced Beneficiary Notice (ABN) on any laboratory procedure that Medicare may not deem as medically necessary. Without a signed ABN on file, MPLN reserves the right to bill the client for any tests deemed not medically necessary.

MPLN bills Medicare through Palmetto GBA in Tennessee and Virginia. MPLN accept Medicare’s allowed rates as 100% of payment. If Medicare pays only a co-insurance amount of the allowed Medicare rate, or if the patient’s deductible is not met, then the patient is responsible for the difference. MPLN accepts the Medicaid allowed rate as full payment. We are enrolled in the following state Medicaid programs: Alabama, Florida, Georgia, Kentucky, North Carolina, Maryland, South Carolina, Tennessee, Virginia, and West Virginia.

At MPLN, we work with each client to set up the best method of payment for them and their patients. The forms of payment we accept are listed below. In addition, patients have the option to pay their laboratory bill online.

Insurance & Third Party Billing

For MPLN to bill an insurance company or third party administrator, be sure to include the following information on the requisition form:

  • Patient’s insurance information
  • All applicable diagnostic codes in ICD-10 format

Patients are responsible for co-payments, deductibles and/or outstanding balances not covered by insurance. If your patient has a question about their laboratory bill, he or she is welcome to call MPLN directly.

Participating Insurance

MPLN is a member of insurance networks across the country. Below you will find the current list of our participating insurance providers.

MPLN participating insurance plans

Patient Billing

We can bill patients directly if the test requisition form is complete and includes the responsible party’s name, address and telephone number.

Client Billing

Our facility fee schedule may be discounted based on a client’s total test volume with MPLN and its subsidiaries. Clients are billed on a monthly basis by an itemized invoice and terms are payable upon receipt. Any adjustments are shown on the following month’s statement. Clients who have collections past due 90 days are sent a written notification. If you have any questions, please call the client billing department at 865.380.9746

CPT Codes

The Current Procedural Terminology (CPT) Codes that MPLN provides in its reports and other literature are based on our interpretation of CPT code requirements and are subject to review and change. It is our clients’ responsibility to verify the accuracy of the codes listed and assign value based on reimbursement for your area. If you have questions about usage of CPT codes, contact your Medicare carrier.
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    Project Management

    Our project managers have strong scientific backgrounds and extensive experience in complex research-based clinical trials. They collaborate with our scientific operations, client services, and commercial operations teams to deliver high-quality, regulatory-compliant testing results on time at every project step.

    Key Features

    • Each study is assigned a dedicated and experienced project manager
    • Studies are typically set up within 6 to 8 weeks of contract signature
    • Project management software tools ensure timely deliveries
    • Onsite customer service teams efficiently resolve queries and deliver reports

    Benefits

    • Accelerated study setup time
    • Responsive communication with the scientific and operational team
    • Testing completed on time and within budget
    • Prompt reporting of critical study data

    Data Management

    The key to a successful clinical trial is accurate, clean, quality data. Our team of data managers provides you with data in customized formats exported to your data management teams from our in-house laboratory information system (LIS).

    Key Features

    • Access to dedicated and experienced data specialists upon contract award
    • Customized reports are agreed upon in study-specific data transfer agreement
    • In-house software development team for custom data solutions
    • Flexible data exports and data transfers

    Benefits

    • Real-time reports for your data and project teams to aid in patient management
    • Guaranteed data integrity and quality
    • Improved decision-making and enhanced patient safety
    • Timely access to accurate, clean data for intermediate or final database lock
    Genomic Solutions

    Genomic Solutions

    Genomic medicine, a vital tool in oncology and drug development by providing deeper, more personalized insights into each patient.

    Beyond informing drug target discovery, validation, and clinical development, it uncovers critical genetic markers that drive disease progression and influence individual treatment responses. This empowers healthcare professionals to create more precise, tailored treatment plans, optimizing medical management based on each patient’s genetic profile.

    DNA Solutions – WGS*, WGMS*, WES*, TSO-500 Comp, Pillar OncoReveal
    RNA Solutions – Total RNA-Seq*, RNA exome*, mRNA*
    Liquid Biopsy Solutions – TSO-500 ctDNA, PGDx elio™ plasma complete*

    Key Features

    • Targeted NGS panels, including FDA-approved assays with companion diagnostic designations
    • Customized bioinformatics and reporting solutions 
    • Robust assay designs to accommodate low-yielding biopsy material
    • Streamlined wet lab processes to meet screening window timelines

    Benefits

    • Identify variants along with key biomarker signatures
    • Save time and money by assessing multiple biomarkers in a single test
    • Enable targeted therapies with actionable, easy-to-interpret results
    • Assists in targeted patient stratification and recruitment
    • Accelerates the development of personalized medicine

    *Offered through fully accredited partner laboratories.

    Digital Pathology

    Digital Pathology

    Digital pathology revolutionizes clinical trials by enhancing accessibility, cost-efficiency, compliance, and data management. MPLN’s comprehensive digital pathology services streamline clinical research, allowing for improved patient outcomes and operational efficiency.

    Key Features

    • Seamless access to digital slides and slide retrieval enables instant access to digital slides.
    • Cost-effective digital slide management streamlines logistics by reducing the need for physical slide storage and transportation.
    • Digital storage ensures slides remain in perfect condition over time.

    Benefits

    • Allows key opinion leaders (KOL) and remote client pathologists to be utilized
    • Digital slides can be easily shared, allowing for faster, more collaborative decisions, including obtaining second opinions.
    • Reduces the costs associated with physical storage and transport of slides, improving trial efficiency.
    • Simplifies regulatory processes, ensuring quicker and more accurate FDA submissions and audit readiness.
    • Prevents slide degradation or breakage, maintaining the quality of research data for the long term.
    • Enables broader patient recruitment by facilitating decentralized clinical trials for wider geographic participation, increasing patient recruitment and diversity.
    Global Logistics

    Global Logistics

    Effective global logistics are the cornerstone of effective specialty laboratory testing supporting global clinical trials. With precious patient samples such as biopsy and bone marrow aspirates, ensuring samples reach the lab on time and within stability is paramount.

    Key Features

    • Partnerships with global specialist couriers and large integrators to support global studies and specialty shipping requirements
    • Ambient, refrigerated, frozen, and liquid nitrogen storage and shipment services available
    • Real-time or batched shipments based on your clinical trial’s individual needs
    • Secure, high-volume, redundant data storage solutions for digital pathology images
    • Expert advice for effective sample collection, handling, and transport
    • Accurate tracking and inventory for all clinical trial specimens

    Benefits

    • Safe and effective transport of specimens worldwide
    • Standardized procedures to reduce pre-analytical variability and ensure valid results
    • Centralized and harmonized specialty pathology testing supported
    • Reduced costs and maximized budgets with fully managed logistics from one trusted source
    • Readily available inventories, manifests, and shipments for timely study closeouts
    Multiplex IHC clinical trial services

    IHC & Multiplex IHC

    Our advanced technology enables simultaneous visualization of single or multiple biomarkers within the same tissue section, delivering comprehensive insights and precise diagnostics. With unmatched expertise and cutting-edge technology, our team supports you in understanding complex tissue microenvironments, aiding patient stratification and treatment response prediction.

    Key Features

    • Simultaneously visualize multiple biomarkers within the same tissue section for deeper insights.
    • Advanced analysis of tissue microenvironments to assist in patient stratification and treatment response prediction.
    • Custom assay design and flexible testing to meet your unique research or clinical trial needs.
    • Our expert team provides detailed data analysis and interpretation to ensure accurate results.

    Benefits

    • Allows enhanced information from small biopsy samples. (I.e. NSCLC)
    • Gain comprehensive insights that lead to more precise diagnostics and better patient outcomes.
    • Enhanced ability to identify patient subgroups and better predict treatment responses more accurately.
    • Whether in biomarker discovery or clinical trials, our advanced technology supports a range of applications, helping you unlock the full potential of your tissue samples.
    Cytogenetics FISH - clinical trial services

    Cytogenetics & FISH

    We offer a comprehensive range of chromosome analysis and fluorescent in situ hybridization (FISH) testing with industry-leading turnaround times and global coverage. Our board-certified lab directors and experienced cytogenetic technologists ensure accurate, efficient, and competitively priced testing with the highest quality of service.

    Key Features

    • Extensive FISH menu of over 40 loci and disease-specific panels detecting gene amplifications, deletions, translocations, and inversions.
    • Testing is available on bone marrow, blood, and FFPE tissue samples.
    • Specialized Offerings:
      • Plasma cell enrichment for plasma disorders
      • Stat turnaround for PML::RARA and acute myeloid leukemia
      • Bladder cancer urine analysis
      • Custom FISH assay development
    • Comprehensive chromosome analysis testing for oncology, infertility, recurrent pregnancy loss, and congenital disorders.
    • Global coverage of equivocal CAP/CLIA services supporting clinical trials

    Benefits

    • Rapid, precise results critical for diagnosis and treatment.
    • Expert-driven testing with Board-certified experts ensures the highest accuracy.
    • Tailored assays and solutions to meet unique clinical needs.
    • Faster diagnostics support timely treatment decisions.