Prior Authorization for genTrue Hereditary Cancer Testing

Most commercial health plans require prior authorization before hereditary cancer testing can be performed. Please follow the process outline on this page for the majority of payers. Please contact 1.877.494.0030 for assistance with specific payers not listed below, or for any other questions.

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General Prior Authorization Process

Please note: this process may vary among individual insurers.

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Once True Health receives the patient’s specimen and all required documentation with signatures, we will guide both patient and clinician through the appropriate prior authorization process. True Health will hold the patient’s specimen until the patient’s payer provides authorization.

What if prior authorization is denied?

  • True Health will make every effort to obtain prior authorization from the patient’s payer, including challenging any denials.
  • If True Health is not able to have a denial reversed, we will contact the patient and o­ffer the option to self-pay at True Health’s cash price by card, check, or money order.
  • If the patient does not wish to self-pay the cost of testing, True Health will send the clinician’s office a cancellation form for notification and clinician signature.

Find My Prior Authorization Forms

Please note: the prior authorization process may vary among individual insurers.

SELECT AN INSURER

Aetna

Complete and submit the following forms to True Health, along with the patient’s medical records, patient specimen, and True Health test requisition.

  1. Aetna Personal and Family History Form
  2. Aetna Coordination of Benefits Form
  3. Informed Consent Form
  4. Genetic Counseling Form

General Prior Authorization Guide: download

Blue Cross Blue Shield

Complete and submit the following forms to True Health, along with the patient’s medical records, patient specimen, and True Health test requisition.

  1. TEXAS ONLY: Blue Cross Blue Shield Prior Authorization Form
  2. DELAWARE ONLY: Blue Cross Blue Shield Medical Necessity Form for BRCA1 and BRCA2
  3. FLORIDA ONLY: Blue Cross Blue Shield Certificate of Medical Necessity for Genetic Testing
  4. Informed Consent Form
  5. Genetic Counseling Form

General Prior Authorization Guide: download

Cigna

Complete and submit the following forms to True Health, along with the patient’s medical records, patient specimen, and True Health test requisition.

  1. Cigna Genetic Testing Recommendation Form 
  2. Risk Assessment Form
  3. Informed Consent Form

General Prior Authorization Guide: download

Humana

Complete and submit the following forms to True Health, along with the patient’s medical records, patient specimen, and True Health test requisition.

  1. Humana Genetic/Molecular Testing Prior Authorization Request
  2. Informed Consent Form
  3. Genetic Counseling Form

General Prior Authorization Guide: download

Tricare

Complete and submit the following forms to True Health, along with the patient’s medical records, patient specimen, and True Health test requisition.

  1. Humana Tricare Military Authorization Form
  2. United Healthcare Tricare Military Authorization Form
  3. Informed Consent Form
  4. Genetic Counseling Form

General Prior Authorization Guide: download

Tufts

Complete and submit the following forms to True Health, along with the patient’s medical records, patient specimen, and True Health test requisition.

  1. Tufts Genetic and Molecular Diagnostic Testing Authorization Request
  2. Informed Consent Form
  3. Genetic Counseling Form

General Prior Authorization Guide: download

United Healthcare

Complete and submit the following forms to True Health, along with the patient’s medical records, patient specimen, and True Health test requisition.

  1. United Healthcare Prior Authorization, Consent, Counseling, and History
  2. United Healthcare Advanced Notice for Non-participating Provider
  3. United Healthcare Pre-Determination Form
  4. United Healthcare Coordination of Benefits Form

General Prior Authorization Guide: download

General Use Forms

Complete and submit the following forms to True Health, along with the patient’s medical records, patient specimen, and True Health test requisition.

  1. True Health Risk Assessment Form
  2. Informed Consent Form
  3. Genetic Counseling Form
  4. Insurance Benefit & Verification Form – Complete this form if patient’s insurance information not captured in full on the True Health test requisition form.

General Prior Authorization Guide: download

Support

True Health has dedicated billing and customer support teams committed to assisting clinicians and patients through the full prior authorization and billing process.

Contact us at:

Phone

1.877.494.0030

Fax

1.844.333.0663