FAQs
Who is Prometheus Laboratories Inc.?Prometheus was founded to develop and provide therapeutic products and diagnostic testing services for patients suffering with chronic diseases and disorders. With a primary focus on the treatment and diagnosis of gastrointestinal, autoimmune and inflammatory diseases and disorders, our goal is to deliver products that enable clinicians to optimize care and make a meaningful difference in their patients’ lives. Our certified clinical laboratory is located in San Diego, California. Many of our tests are proprietary and/or patented and may not be available at your local laboratory. Who do I contact with questions about your pharmaceutical products?Prometheus offers medical information assistance. We generally have a registered nurse available by telephone during regular business hours. To report an adverse event or for information about Helidac®, Imuran®, Ridaura®, Trandate®, Zyloprim®, or mercaptopurine, call (888) 423-5227, Opt. # 6. To report an adverse event or for additional information about ENTOCORT® EC, call (888) 423-5227, Opt. # 5. What is a Prometheus test?Prometheus performs highly specialized laboratory tests at the request of a licensed physician or other authorized health care provider. Many of our tests are patented and proprietary. Your physician or local laboratory may forward your specimen to our facility because comparable testing may not be otherwise available. Click here for information about our individual tests. How do I order a test at Prometheus?Prometheus is a certified clinical laboratory that performs highly specialized laboratory tests only at the request of a licensed physician or other authorized health care provider. Laboratory draw sites across the country can collect specimens to be shipped for testing at our laboratory in San Diego, California. Prometheus offers specimen transportation kits at no charge to expedite the shipping of samples to our facility. Test kits can be sent to you, your doctor, or local laboratory. Contact Client Services to locate a lab near you or to order a kit. Do I need to prepare for a Prometheus test in any way?Urea breath testing for H. pylori requires a one-hour fast prior to having your breath specimen collected. Please check with your doctor’s office for other testing requirements. Currently, no blood test offered at Prometheus requires fasting prior to having your specimen collected. How do I find a laboratory to collect my specimen for Prometheus testing?Contact Client Services at (888) 423-5227, Opt. # 3 to locate a laboratory draw site near you. When will my test results be available?Most test results are available to your doctor within 2-4 days from the receipt of your sample. Although samples typically reach Prometheus within 24 hours of collection, it often takes a few days to process all of the patient, doctor and test information. You may contact Client Services at (888) 423-5227, Opt # 3 to check the status. NOTE: Test results are only available to a licensed healthcare provider responsible for your medical treatment. Will you provide me with a copy of my test results?Prometheus is unable to provide a patient with a copy of test results. A report will be sent to the ordering physician or authorized health care professional in accordance with test result disclosure laws. Who can help me understand my test results? Prometheus diagnostic services provide important information to aid in the diagnosis and management of certain diseases. Test results should be used with other clinical and diagnostic findings to help your physician make a diagnosis. How do I find out how much a test will cost me?Due to the nature and variety of testing and insurance policies, we recommend contacting our billing department at (888) 892-8391 for specific pricing and payment options. Prometheus offers a variety of specialty testing services that may not be available at your regular laboratory facility. We also recommend checking with your own insurance company about reimbursement and the need for a prior authorization before having your specimen collected. Does Prometheus offer patient assistance?Prometheus does not currently offer patient assistance for any of our pharmaceutical products. Will my insurance company pay for this test?Your insurance company will process a claim for Prometheus testing services according to guidelines and benefits outlined in the insurance policy that you have purchased. Your insurance company may require a prior authorization or referral before having your specimen collected. The ordering physician or the patient is responsible for obtaining this authorization. Prometheus offers sample letters of correspondence and other materials to assist you or your physician in this process. Prometheus cannot guarantee reimbursement from your insurance company. Unpaid balances may be the responsibility of the patient or guarantor. Payment is due upon receipt of an invoice from Prometheus. The fact that a plan may not pay for a particular test does not mean that it is inappropriate for your medical care. This is determined by your physician. Laboratory testing services from Prometheus may require some out-of-pocket expenses for deductibles, co-pays, co-insurance, and non-covered services. Prometheus does have agreements with certain laboratories across the country which may help reduce your out-of-pocket expense. Contact our Client Services to locate a laboratory near you. Will Prometheus file a claim with my insurance company?As a courtesy, Prometheus will bill your primary insurance for services performed as long as we have been provided with complete and accurate insurance information. This includes the subscribers name, date of birth, the subscriber’s ID #, the employer name and group #, and the insurance claim address and phone number. We ask that you provide us with a legible copy of your insurance card (front and back) whenever possible. Prometheus cannot guarantee reimbursement from your insurance company. Unpaid balances may be the responsibility of the patient or guarantor. Payment is due upon receipt of an invoice from Prometheus. Prometheus does not automatically submit a claim to your secondary insurance carrier, but we can bill them on your behalf provided complete information is available. Our billing department is available to assist you with your claim and charges due. Does the Prometheus test my doctor ordered require a prior authorization?You will need to review your insurance contract or contact your insurance company directly to verify if testing performed at Prometheus requires a prior authorization. Our tax ID number 33-0685754 will help your insurance carrier’s customer service department determine if such authorization is required. If a prior authorization is required, we have provided sample letters of correspondence for you and your physician to help with this process. Contact our billing department at (888) 892-8391 with any questions. Does Prometheus accept Medicare?Prometheus is a Medicare participating provider. Why have I received a letter from Prometheus?A courtesy letter from Prometheus will inform you that we intend to file a claim with your insurance company on your behalf. You will receive a separate letter for every test performed. Each test will have a unique Reference Ticket Number; this number is helpful when corresponding with us. Please carefully review the information provided. Contact our billing department as soon as possible to correct any errors. If you have already received an Explanation of Benefits (EOB) from your insurance company, please forward a copy of this document along with any payment to our billing department. This will allow us to accurately credit your account and determine if any amount is still due. I believe that the test provided should have been paid by my insurance company. What should I do?Carefully review your Prometheus invoice as well as any Explanation of Benefits (EOB) from your insurance company to verify that all the information is correct. If there are no errors but you still feel that your insurance should pay your claim, we recommend that you contact your insurance company’s Customer Service Department. You may want to confirm that they did receive a claim from Prometheus. We recommend asking for a detailed explanation of how the claim was processed and what their procedures are for filing an appeal. As a courtesy, Prometheus offers sample letters of correspondence to assist with this process. We also recommend maintaining a communication log of any discussion or correspondence with your insurance representative. If your insurance company requires additional information from Prometheus or you have any questions at this point, contact our billing department. How do I contact someone at Prometheus to discuss my bill? Prometheus billing department can be reached Monday–Friday between the hours of 6:00am and 4:30pm PT (Closed from 12:00-1:00pm PT Thursdays) What methods of payment does Prometheus accept?Payment for services is due upon receipt of an invoice from Prometheus. We accept payment by check, money order, and most major credit cards. To ensure that your payment is processed correctly please include the patient name and patient reference ticket number(s) / ID number with your payment. Credit card payments can be processed by phone, fax, or mail using our Credit Card Authorization form. Payment by mail should be sent to: Prometheus Laboratories Inc. Contact our billing department with any questions. What should I do if an insurance payment is sent directly to me for a test performed by Prometheus?It is possible that insurance payments and Explanation of Benefits (EOB) may be sent directly to you from either your primary or secondary insurance carrier. You can sign the back of the insurance check. Underneath your endorsement write “Deposit Only: Prometheus Laboratories Inc.” and forward it to our billing department. You may also deposit the insurance check and send us a personal check for the amounts owed. It is important that you forward a copy of your insurance EOB in order for us to process your payments correctly. My insurance company needs the CPT or procedure codes for my test; what are they?CPT codes are five-digit codes that are used to identify services and procedures that are provided by health care providers. These codes are developed and maintained by the American Medical Association. Many of these codes are “generic” and may be used to describe several distinct services. Some codes are followed by a multiplier (eg. 83520 X 5) indicating that a procedure code is billed more than once for a particular service. When providing your insurance company with Prometheus’ CPT code descriptions for each of our tests, you must provide all of the codes with their multipliers and descriptions so that the insurance company can properly determine your potential reimbursement. A prior authorization is not a guarantee of payment. My doctor ordered a PROMETHEUS® Thiopurine Metabolites Test. What is this for?PROMETHEUS Thiopurine Metabolites is a test to monitor thiopurine medications. Because everyone metabolizes medications differently, your doctor may order this test to make sure your level of treatment is within a range that may help control symptoms. |
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