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Genetic Labs

Houston, Texas

Genetic Laboratory
Baylor Miraca Genetics Laboratories
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Billing

Baylor Miraca Genetic Laboratories provides convenient billing programs for our valued clients. We offer the following full service billing services and payment options.

Policies and Information

Institutional Billing
Insurance Billing
Self-Pay Prepayment
CMA (Pre/Post-natal) Payment Options
Prenatal Biochemical & DNA Comprehensive Charge
International Client Payment Options
Test Cancellation due to Financial Matters
Contact Information & Tax ID
Health Insurance Portability and Accountability Act (HIPAA) Privacy Notice for Patients

Forms

Institution Agreement
Credit Card Payment Authorization
Tax ID W-9
Statement of Medical Necessity
Advanced Beneficiary Notification (ABN)
Authorization for Release of Protected Health Information - HIPAA (English)
Authorization for Release of Protected Health Information - HIPAA (Spanish)
Patient Insurance Benefit Verification

Institutional Billing

Referring clinics, hospitals, labs, and/or physicians may establish Institution accounts with convenient monthly invoicing and payment options (excludes international clients).

A completed Institution Agreement Form or Laboratory Services Agreement must be on file in the Billing office for account approval.

You may select the option to establish an institution credit card payment account.

Please direct all institution billing inquiries to , or call 713-798-5849.

Institutions must provide signed authorization from any other agent designated as the guarantor for charges.

Tests received with institutional billing instructions cannot be revised to bill insurance.


Insurance Billing

  • Complete insurance information is required on the patient requisition form for testing to be billed to insurance. Testing is not initiated until complete information is received.
  • Required insurance information includes:
    • HMO authorizations
    • ICD9 codes
    • Legible front/back copy of insurance cards
    • Authorized signature for Release of Information and Benefits.
  • Insurance verification/preauthorization is performed by request or when required by insurance. Insurance verification and preauthorization is not a guarantee of payment. If you would like our billing specialists to perform an insurance verification prior to sending your patient's sample, please fill out this form and fax it to 713-798-4187.
  • Patients may be liable for fees due to insurance coverage benefit limitations, contract exclusions, non-covered services, non-authorized services, deductibles, insurance co-pays, co-insurance, or balances after non-contracted insurance reimbursement. Please contact the patient billing staff for payment terms on account balances at:
  • Please contact our office for assistance and approval prior to securing HMO authorization for your patient.
  • The complete list of managed care contracts is available.

Medicare:

Medicare reimbursement for genetic testing is limited, and in some cases, is dependent on Local and National Coverage Determinations. In some cases, an Advanced Beneficiary Notification is required for approved Medicare samples. Please contact medgenbilling@bcm.edu prior to test submission to determine if an ABN is required and to prevent any delays in sample processing.

Tricare/Triwest (Champus):

Baylor Miraca Genetics Laboratories is not contracted with Tricare/Triwest (Champus). Please contact our office with Tricare/Triwest (Champus) billing questions.

HMO/Texas Medicaid Authorizations-Single Case Letters of Agreement:

Please contact our office for assistance and approval prior to securing single case agreements or HMO authorization for your patient. Agreements or authorizations developed without specific laboratory information cannot be accepted.

Physical Address:
Baylor Miraca Genetics Laboratories, LLC
2450 Holcombe Blvd, O100
Houston, TX 77021-2039

Payment Address:
Baylor Miraca Genetics Laboratories, LLC
PO Box 847228
Dallas, TX 75284-7228

Tax ID: 47-2290309


Self-Pay Prepayment:

See Credit Card Payment Authorization Form

The Baylor Miraca Genetic Laboratories accepts checks (payable to Baylor Miraca Genetics Laboratories, LLC), money orders, and approved credit card (AMEX/Discover/MasterCard/Visa) payments. Discounts may apply on Self-Pay samples. Please contact our billing office with any questions.

Prepaid Samples

We accept checks, money orders, credit card payments, and wire transfers. Please make checks and money orders payable to Baylor Miraca Genetics Laboratories, LLC. There is a $20.00 processing fee for insufficient check payments.

Credit Card Payments

Approved credit card (AMEX, Discover, Mastercard, or Visa) payments are accepted. The card type, cardholder name and signature, credit card account number, expiration date, CVC security code, and e-mail address must be provided.

Wire Transfers

Payments can be made via wire transfer from your bank. The bank identification information is referenced below. Please forward documentation to our business office at or when a wire transfer is performed. The following is the information needed for wire transfers:

Recipient Bank Information:

Bank of America
Merrill Lynch
901 Main St.
Dallas, TX 75202
Phone: 214-209-3282

Account Number: 488038524769
ACH Debits/Credits: 111000025
Wires: 026009593
SWIFT: BOFAUS3N
Reference: Baylor Miraca Genetics Laboratories


Chromosomal Microarray Analysis (CMA) Prenatal & Postnatal Billing Options:


Prenatal Biochemical & DNA Comprehensive Charge:

One standard fee is charged for prenatal tests performed by biochemical or DNA procedures. The comprehensive charge includes testing on the maternal, fetal, and paternal samples. Twin samples are charged two standard fees. This does not apply to prenatal diagnoses performed by the Cytogenetics Laboratory or Prenatal CMA. Please contact our genetic counselors at 1-800-411-4363 prior to prenatal sample submission.


International Client Payment Options:

Important Note for our International Clients:

International samples must be prepaid by credit card, check, or wire transfer at time of sample submission. Testing is not initiated until payment is received and processed. Itemized receipts are provided upon request. The receipts may be used for clients to file with international insurance carriers. International insurance is not filed by the Baylor Miraca Genetics Laboratories.

International Payment Options:

Prepaid Samples

Prepaid samples may receive a discount when required payment is received with the sample. We accept checks, money orders, credit card payments, and wire transfers. Please make checks and money orders payable to Baylor Miraca Genetics Laboratories, LLC. There is a $20.00 processing fee for insufficient check payments.

Credit Card Payments

Approved credit card (AMEX, Discover, Mastercard, or Visa) payments are accepted. The card type, cardholder name and signature, credit card account number, expiration date, and e-mail address must be provided.

Wire Transfers

Payments can be made via wire transfer from your bank. The bank identification information is referenced below. Please forward documentation to our business office at or when a wire transfer is performed. The following is the information needed for wire transfers:

Recipient Bank Information:

Bank of America
Merrill Lynch
901 Main St.
Dallas, TX 75202
Phone: 214-209-3282

Account Number: 488038524769
ACH Debits/Credits: 111000025
Wires: 026009593
SWIFT: BOFAUS3N
Reference: Baylor Miraca Genetics Laboratories

Financial Office Contact:

Kim Stafford

Phone: 713-798-5849
Fax: 713-798-4187
P.O. Box 4832
Houston, TX 77210-4832


Test Cancellation due to Financial Matters:

The Baylor Miraca Genetics Laboratories Cancellation Policy includes tests cancelled due to financial matters.

Tests that do not meet the criteria listed below will be cancelled. Once financial criteria are met, the test will be performed. If financial responsibility is not established, the test will remain cancelled.

Reasons for financial cancellation include but is not limited to the following:

  • Self-Pay samples without payment
  • International samples without payment
  • Insurance samples without complete billing information (including diagnosis codes and ordering provider's name)
  • Non-contracted out-of-state Medicaid or welfare programs
  • Medicare samples without required ABN forms
  • HMO or Medicaid HMO samples without required authorization
  • Non-contracted insurance carriers
  • Financially abandoned samples
  • Non-established institutions requesting institutional billing terms

Mailing Address & Contact Information:

Billing Department

Phone: 713-798-3566
Fax: 713-798-4187

Physical Address:
Baylor Miraca Genetics Laboratories, LLC
2450 Holcombe Blvd, O100
Houston, TX 77021-2039

Payment Address:
Baylor Miraca Genetics Laboratories, LLC
PO Box 847228
Dallas, TX 75284-7228

Tax ID: 47-2290309

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