To ensure that a patient’s test is billed to their 2024 health benefits, testing must be started before the end of the year. For exome, genome, or Xpanded testing, if you do not expect parental samples to be received before the end of the year, please contact us at support@genedx.com to determine how to proceed.
Use the links below to access forms related to ordering GeneDx exome sequencing, genome sequencing, and more.
The most efficient way to place an order is via our online portal; however, orders may also be placed by completing one of the TRFs linked below and submitting it with the patient sample. For questions, please contact Client Services (phone: 301-519-2100, option 3; email: Support@GeneDx.com; fax: 201-421 2010).
Please note: GeneDx does not accept orders or patient samples from the UK or EU countries at this time.
GeneDx’s standard patient informed consent form can be found below in several languages. The English version is also appended to all test requisition forms. Information related to sample retention and database participation is included in the consent forms.
If a patient would like to opt-out of being recontacted for research participation, opt-out of sharing deidentified data with collaborators, update their health information exchange (HIE) preferences, or request the discarding of their sample, please use the additional forms below.
Below are forms related to the insurance billing process, including templated letters of medical necessity and forms related to the Early and Periodic Screening, Diagnostic, and Treatment (EPSDT) program.
Insurance plans often require specific prior authorization forms for genetic testing. While many of these forms are available in the GeneDx Provider Portal, please check with your patient’s insurance provider for the latest requirements.
Please see the EPSDT state attestation forms below. If your patient resides in the following states, physicians should use the general EPSDT attestation form linked below: Alaska, Colorado, Delaware, District of Columbia (D.C.), Hawaii, Kansas, Louisiana, Maine, Mississippi, Montana, Nebraska, New Hampshire, New Mexico, Rhode Island, South Carolina, Vermont, and Wyoming.
The following states require a state-specific EPDST form:
We offer a robust Financial Assistance Program to help reduce the potential out-of-pocket costs associated with testing. Our Financial Assistance Program webpage offers additional information and a tool to estimate the level of assistance a patient may qualify for.
Patients will automatically receive a financial assistance application form (below) with their final bill. Patients should complete and sign the application form and submit it to Billing@GeneDx.com only after receiving their final bill.
To learn more about our comprehensive genetic counseling services for patients tested by GeneDx, please visit our genetic counseling webpage. To request services for your patient, please complete the referral form below and return it via email (Referral@GeneDx.com) or fax (201-605-6582).
For GeneDx to release a copy of a patient’s test results to someone other than the ordering provider, please contact our Customer Service team at 888-729-1206, option 3, or email Support@GeneDx.com. To request raw data on patients (e.g., sequencing files), please contact our data send out team at Clinicalgenomicsdata@GeneDx.com.
