Billing & Access

You order a CareDx test based on your independent clinical judgment.

An EOB is not a bill, and you no payment is due at that time.

If the claim is denied, the insurer notifies both the patient and CareDx. CareDx may contact the patient to obtain permission to support the appeals process with the insurer. Appeals may take several months, and additional EOBs or letters from the insurer during this time are standard.

CareDx tests are covered by Medicare and Medicare Advantage when medical necessity criteria are met. Coverage for commercial and Medicaid plans varies, and we are continuously adding new insurers.

Most AlloMap and AlloSure patients have no out-of-pocket costs. Patients may receive an Explanation of Benefits (EOB) from their insurance provider. This is informational only and not a bill. If out-of-pocket costs do apply, patients may apply for our Financial Assistance Program.

If a claim is denied, CareDx will work to appeal the denied claim and may ask the patient for assistance.

CareDx accepts and processes in-patient orders, and billing is handled in accordance with the patient's insurance type and insurance-specific requirements.

Prior authorization is required by many insurers to confirm medical necessity. Most of the time CareDx is able to handle the prior authorization process with insurance; in some cases we will need your assistance.

Your patients may be eligible if they have commercial coverage, provided they meet the FAP eligibility criteria and: a) Insurance does not cover the CareDx test OR b) Insurance does cover the CareDx test but applies a patient cost-share.

The program is available to your patients if they meet the FAP eligibility criteria at the time of the application. For more information on the eligibility criteria and Financial Assistance Plan terms and conditions, contact the CareDx Reimbursement Team at: 

Phone: 1-866-383-1924 Email: financialassistance@caredx.com 

If approved, your patients will be eligible for up to 12 months of assistance. If longer assistance is required, they can reapply on a yearly basis.