Billing Process Overview
We strive to make the billing process straightforward and transparent. From test order to payment collection, our team is here to support you every step of the way.
Test Order Placed
When the ArteraAI Prostate Test is ordered, insurance information is submitted to Artera as part of the ordering process.
Benefit Investigation (BI)
Artera reviews insurance details to confirm coverage and estimate any out-of-pocket costs. If costs are expected to exceed $285, Artera will attempt to contact the patient to discuss benefits, financial responsibility, and available payment options. Prompt responses help us provide clear cost information and avoid delays.
Claims Submission
After the test is completed, Artera submits a claim directly to the insurance company. Any issues that arise during this process will be addressed to minimize disruptions
Patient Receives Explanation of Benefits (EOB)
An EOB will be sent by the insurance company. This document explains how the claim was processed. Please note: this is not a bill. It’s simply a statement of what insurance covered and what financial responsibility there may be.
Statement Generation
Once the insurance company processes the claim, Artera calculates any remaining patient financial responsibility. A detailed statement is then sent by mail, outlining the test cost, insurance payments, and any balance due.
Payment and Collections
Artera offers flexible payment options, including payment plans and a Financial Assistance Program, to help reduce financial barriers and ensure patients can access the care they need.
We offer a Financial Assistance Program to help reduce the potential out-of-pocket costs associated with testing. The program has broad eligibility criteria, meaning that most patients with out-of-pocket costs will qualify for some level of financial assistance.
The table provides guidance on qualifying for financial assistance based on household size and income. It’s a quick and easy way to understand available options and take the next step toward applying.
| Household Size | $0 cost to patient if household income is less than: | $95 cost to patient if household income is less than: | $190 cost to patient if household income is less than: | $285 cost to patient if household income is less than: |
|---|---|---|---|---|
| 1 | $46,950 | $62,600 | $78,250 | $93,900 |
| 2 | $63,450 | $84,600 | $105,750 | $126,900 |
| 3 | $79,950 | $106,600 | $133,250 | $159,900 |
| 4 | $96,450 | $128,600 | $160,750 | $192,900 |
| 5 | $112,950 | $150,600 | $188,250 | $225,900 |
How to apply:
Step 1
Download and complete the Financial Assistance Application.
Step 2
Complete the application and email it to billing@artera.ai. A scanned copy or picture of the completed application is acceptable.
Step 3
We will contact you regarding approval within two business days. To avoid any delays, please fill out all fields in the application. Additional information may be required.
Financial Assistance Application
The Artera Financial Assistance Program (“Program”) is designed for qualifying patients who are uninsured or are insured under a commercial insurance plan.
Financial Assistance Application - Spanish
El programa de asistencia financiera de Artera (“el Programa”) está diseñado para pacientes elegibles que no están asegurados o que están asegurados con un plan de seguro comercial.
Frequently asked questions
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The out-of-pocket cost for the ArteraAI Prostate Test will be based on your insurance plan. If you are covered by Medicare Plan B, you should have zero out-of-pocket costs for the ArteraAI Prostate Test. If you are covered by private insurance, financial liability will be subject to the terms of your plan taking into consideration copays, coinsurance and deductibles. You should contact billing@artera.ai for additional details about the estimated out-of-pocket liability for the test.
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If a patient has secondary insurance and the primary insurance denies the test, Artera will submit a claim to the secondary insurance. The secondary insurance will review the claim and apply its plan policies to determine coverage and any financial responsibility.
If you have questions about how secondary insurance might apply, feel free to contact us for more information.
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Artera assumes responsibility for addressing claim denials, including filing appeals when necessary. In some cases, we may need the clinic to provide medical records to support the appeal. Additionally, certain insurance companies may require the patient to give permission for Artera to appeal the denial on their behalf.
If the appeal is successful, patients will only be billed for the amount determined by their insurance, if any. If the appeal is not successful, we will work with the patient to explore payment options or financial assistance to minimize any financial burden.
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Patients can generally expect to receive a bill within 30 days from the date the insurance claim is finalized.
If you have any questions or concerns about the status of a bill, please don’t hesitate to contact us for updates and assistance.
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Artera will send a bill after the test by mail. Payments can be made conveniently using one of the following methods:
- By Mail: Send a check or provide your card information.
- By Phone: Call to make a payment using a credit card.
- Online: Access our secure payment portal via the email link provided with the bill.
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Yes! The Artera Financial Assistance Program supports those who may need help managing the cost of the test. It’s available for patients who are uninsured or have a commercial insurance plan.
However, patients insured through federal programs, such as Medicare Part B, Medicare Advantage, Medicaid, or Tricare, are not eligible for this assistance.
If you’re unsure about your eligibility, reach out to our team or download the Financial Assistance Application (English, Spanish) to learn more.
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Results can be shared within 2-3 days after receipt of the patient’s specimen.
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