Changes in Laboratory Fees and Coverage FAQ’s:
As of February 10, 2020, all laboratory testing performed by Vibrant America laboratories will no longer be covered by insurance. Please see details below for how this may affect you, including new pricing and other lab alternatives.
What is a “cash” model?
A cash model allows a health care client to choose labs from a menu of options and know exactly how much the labs will cost up front. No billing, no EOBs, no calls, no letters, no surprises down the road.
What will the cost be?
Vibrant is pricing their tests 20% below the rates typically reimbursed by Medicare. We will have a menu of pricing available on our website and at the clinic so that you and your physician can choose the panels you desire ahead of time. When the staff calls you to schedule labs, they will be able to tell you exactly how much the labs will cost if you are using Vibrant.
Can we use Labcorp or Quest?
Yes, we can continue to use these labs if you desire to do so. At the beginning of the year, if you have not met your deductible, these larger national labs will charge you based on their contracted prices, which will typically be much higher. On the other hand, if you know that you have met your deductible and that one of these labs is in network with your insurance company, it may be more cost-effective to use a lab like Quest or LabCorp.
Note: Even if a deductible has been met, it is possible that an insurance company deems that certain lab parameters (past examples include: homocysteine and reverse T3) are experimental and/or not medically necessary, and therefore the labs will not be covered.
The key with these labs is that you are well aware of your deductible and that you are O.K. with the possibility that not all tests will be covered.
What about Medicare & Tricare?
Because most labs billing insurance contract directly with Medicare and Tricare, we believe that in this instance it makes sense to use a lab that bills insurance.
Note: It is still possible that Medicare and Tricare deem a test to be not medically necessary and that you will receive a bill from the lab for these tests.
Some labs like Genova Diagnostics still offer zero out-of-pocket for Medicare clients, so we anticipate using them more in these cases.
What about Medicaid?
At the moment, we are able to use Quest diagnostics for our Medicaid patients without any out-of-pocket expenses.
Who would I pay for a Vibrant lab panel?
Once you agree to do a specific panel, you would pay the clinic the predetermined amount, ideally prior to your lab appointment. We will work with Chantee next door to ensure that the Vibrant cash panels are paid by the time of the blood draw.
Can I use a Vibrant panel if I live out of state?
Yes. We can ship a kit with supplies and instructions, and you would need to find a draw center in your area. The kit will have a pre-paid label so it can be shipped directly to Vibrant from the draw center.
Can I submit the cost of the lab to my insurance?
Yes. The clinic will print out a super-bill that you can submit to your regular insurance or health share program.
Do I still need to pay a draw fee when I come in for the labs?
Yes. The lab next door is a separate entity from Restore Health, and they charge a draw fee for their phlebotomy services, much like other specimen-collection companies, such as Mile High in Denver or ABO labs in Northern Colorado.
Are there other labs that we could use?
Current changes affect only Vibrant America panels. All other lab offerings remain the same.
We are committed as a clinic to offer our clients the best care available at the most cost-effective pricing. Toward that end, we are always investigating available labs and are open to working with new labs in the future. We can also order any lab available in the U.S. if we feel that it is in the best interest of our clients. Please see our website for a list of laboratory offerings.
