The Center for Genetics at Saint Francis offers multiple billing options to better serve our clients and patients. Before testing may begin, all of the information required on the Test Requisition Form must be received. Please review all of the billing options and the respective paperwork that is required upon receipt of a specimen to avoid delays in testing.
CPT Code List
Test Requisition Form
Questions about pricing? Contact Lynne Whetsell at [email protected]
Questions about billing? Contact Diane Ketchelmeier at 918-494-1345 or [email protected]
Payment Options
Client/Institution Orders
Referring institutions and physicians may establish institution accounts with monthly invoicing. To establish an institution account, please fill out the Billing Information page of the test requisition form. Information regarding Institutional pricing, turnaround times and CPT codes are available on the Genetics Fee Schedule.
International Client/Institution Orders
International clients must include payment with the shipment of the specimen. Checks or money orders should be made payable to Saint Francis Hospital. Approved credit card payments by Visa, Mastercard or American Express are acceptable if the following information is included: card type, cardholder name, card account number, expiration date, three-digit security code and amount being paid.
Wire transfers are also accepted. The following information is needed in order to process the payment appropriately.
- Bank Information: Midfirst Bank | Account name = Saint Francis Hospital Inc. | Account title = SFH Operating Account
- Address: 2201 S. Utica Place, Suite 200, Tulsa, OK 74116
- Account Number: 6301013262; Routing number: 303087995; Swift Code# MFBKUS44
- Document in Memo: Department #515060-64110, patient name, patient DOB, and hospital account number (if given)
- Notify the laboratory supervisor at 918-502-1730 or [email protected] at the time the wire transfer is initiated or include wire transaction receipt with the specimen
Patient Self-Pay
Discounted fees are applied to patients who choose to self pay and send payment upfront with the test order. Cash and personal checks or money orders made payable to Saint Francis Hospital will be accepted. Approved credit card payments by Visa, MasterCard or American Express are acceptable if the following information is included: card type, cardholder name, card account number, expiration date, three-digit security code and amount being paid.
Insurance
Insurance is filed as a courtesy and the patient is ultimately responsible for the balance of the account. Patients should contact their insurance company to verify insurance coverage or make arrangements for prepayment. Insurance billing for referring institutions or out of state patients is limited. The billable plans for out of state referring facilities and patients are Aetna, Blue Cross Blue Shield, United Healthcare and Cigna.
The following must be submitted for insurance billing:
- Billing Information page of the Test Requisition Form with patient's signature (patient demographic information may be provided in the form of a clinic face sheet). If patient is a minor, the DOB and contact information of the policy holder is required.
- Front and back copy of Insurance card
- Preauthorization number or written statement from insurance company stating authorization is required.
- Clinical documentation for testing
Medicare/Medicaid
Saint Francis is a Medicaid provider for patients within the state of Oklahoma and bordering states. We are not able to bill Medicaid in any other states. Complete information as requested on the requisition form must be received for billing.
Saint Francis is also a Medicare provider; click for complete information on CMS National Coverage Determination.
CPT Codes
The American Medical Association's Current Procedural Terminology (CPT®) codes are provided for informational purposes only. The codes reflect our interpretation of the CPT requirements based on our methodology of testing and the published AMA guidelines. CPT codes are provided only as a guide to assist our clients with billing and it is recommended that the use of these codes be confirmed with your respective Medicare administrator.