Billing Forms

Insurance Verification and Authorization

As a service to our clients and your patients, we perform verification of insurance benefits. To take advantage of this service, have your patients complete and sign our Patient Insurance Benefit Verification Form (EGL VOB Form) prior to shipment of the sample. If a patient prefers to perform verification of benefits himself/herself, he or she can use the Patient Insurance Benefit Self Verification Form (Self VOB Form), which will walk him/her through the complicated verification process. Click the links below to access the forms. Please note that the information provided on a verification of benefits is not a guarantee of payment on any of the services EGL provides. Pre-/Prior-authorizations only verify that the requested service meets the benefits plan's definition of medical necessity and is not a guarantee of payment.

Patient Insurance Benefit Self Verification Form

Patient Insurance Benefit Verification Form

Advance Beneficiary Notice of Noncoverage (ABN)

EGL Genetics requires an ABN be completed for all genetic test orders being billed to Medicare. The ABN is a notice given to beneficiaries to convey that Medicare may not provide coverage in a specific case and that the beneficiary may be financially responsible for services Medicare doesn't cover. For questions, please contact our Billing department at Viracor at 816-251-0395 or 1-888-875-7307 or eglbilling@viracor-eurofins.com. Click the link below to access the form.

Advance Beneficiary Notice of Noncoverage

New and Updated Gene Panels

Industry-leading number of gene panels

EGL Next Generation Sequencing Panels include comprehensive, evidence-based gene lists, improved turnaround times, and reduced pricing.