1. About this testing

Your healthcare provider has ordered laboratory testing to support your care. This testing is performed by Enable Biosciences, Inc., an independent CLIA-certified, CAP-accredited clinical reference laboratory. These Terms explain how the testing is billed, what you may owe, and how we handle your information. By signing the Test Requisition Form, you agree to these Terms.

2. What you will pay

Your total cost for this testing will never exceed $189, regardless of your insurance status or what your plan decides to cover.

If you use insurance

If you ask us to bill insurance, we will submit a claim to your plan. Your plan may not cover the full cost, and you may owe amounts such as a deductible, co-insurance, co-payment, or amounts for services your plan considers "non-covered" or "not medically necessary." Even so, the total you pay Enable for this testing will not exceed $189.

If you do not use insurance (self-pay)

If you are uninsured or choose not to use insurance, your cost is a flat $189. You are entitled to a Good Faith Estimate before testing (see §7).

3. If you have Medicare

Medicare does not pay for every test. Two situations are different, and we will tell you which applies to you before you owe anything:

•      Tests Medicare never covers (for example, certain screening tests). Medicare does not pay for these by law. If your test falls in this category, we will give you written notice before testing so you can decide whether to proceed at your own cost.

•      Tests Medicare may deny as "not medically necessary." Before we can bill you for a test in this category, we will give you an Advance Beneficiary Notice of Noncoverage (an "ABN") that names the test, the reason Medicare may not pay, and the estimated cost, and asks you to choose an option. You are only responsible for a denied test if you received and signed that notice in advance.

4. If you have Medicaid

If you are a Medicaid beneficiary, you will not be balance-billed. You owe nothing for this testing beyond any amount Medicaid rules permit us to charge you. The financial-responsibility terms in §2 do not require you to pay any balance that Medicaid prohibits.

5. If Enable is out-of-network with your plan

If Enable is not in your insurance plan’s network, your plan may pay less, but this does not change the limit in §2: your total cost for this testing will still not exceed $189.

6. Insurance benefits, and letting Enable act for you

When you sign the requisition, you assign your insurance benefits to Enable and direct your insurer to pay Enable directly. You also appoint Enable as your authorized representative so that Enable can submit, pursue, and appeal claims for this testing on your behalf, request the plan documents needed to do so, and release the information required to process and appeal the claim. This appointment applies even if your plan’s documents limit your ability to assign benefits.

7. Good Faith Estimate (No Surprises Act)

If you are uninsured or choose not to use insurance, you have the right to a Good Faith Estimate of the cost of this testing before it is performed. Because the self-pay price is a flat $189, that is your Good Faith Estimate. A written copy is available on request and is provided with your kit.

8. Credit reporting

Enable does not report unpaid balances for this testing to consumer credit reporting agencies.

9. How we contact you

Enable may contact you about your order, your results, and your bill by phone, text message, email, or mail. By providing your phone number, you agree that Enable and its billing partners may contact you at that number, including by automated dialing or text, about this testing and your account. Consent to automated messages is not a condition of receiving testing, and you may opt out of texts at any time by replying STOP.

10. How you receive results

Your results are released to the ordering provider named on your requisition. If you ask us to send results or account information to you directly by email or fax, we will use the method you request. Standard email is not fully secure; if you ask us to email you at an address that is not secured, you accept the risk that others could access that message.

11. Your privacy

Enable uses and discloses your health information to perform your testing, to bill for it, and to run our laboratory operations, as described in our Notice of Privacy Practices. This includes sharing the information needed to process and appeal your insurance claim with our billing and revenue-cycle partners. You can read our full Notice of Privacy Practices at the link on your requisition.

12. Your specimen

Enable may retain your dried blood spot specimen for the time required by law and for quality and operational purposes. If your provider ordered follow-on or confirmatory testing on the same specimen, we may perform it as part of your order.