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Signatera Bill: What It Costs and How to Get Help Paying

Signatera Bill: What It Costs and How to Get Help Paying

Signatera Bill: What It Costs and How to Get Help Paying

About this blog post: If you are getting bills from Natera after Signatera testing, this guide explains why a new bill can arrive every few months, how to tell which test each one is for, and what to check before you pay.

Key takeaways

  • If a Signatera bill doesn't look right, Granted may be able to help. Our health advocates can check it for errors, work with Natera to lower the balance, and appeal a denial if you want us to. It's free to start, and you only pay if we lower your bill.

  • The amount on your EOB (explanation of benefits), the statement your insurer sends after it processes a claim, is not final. Natera may still lower it, so wait for Natera's bill and ask Natera to hold it while you check.

  • A denial is not the last word. You generally have 180 days to appeal, and your doctor's office can send the records that show you needed the test.

  • Natera offers financial assistance if you qualify. Typically one approval covers your future tests, so you do not reapply for each bill.

What is Signatera by Natera?

Signatera is a blood test made by Natera that looks for circulating tumor DNA (ctDNA), which is tiny pieces of DNA that cancer cells shed into the blood. Doctors use it to check for molecular residual disease (MRD). MRD is small amounts of cancer left after treatment, too small to see on a scan.

Signatera is tumor-informed, which means the test is built from your own tumor. According to Natera's Signatera FAQ, the first test uses your tumor tissue plus a blood draw. Later tests use blood draws only. Natera says the first result takes about 3 to 4 weeks, and later results usually take 7 to 10 days.

What is on a Signatera bill?

A Signatera bill is the statement Natera sends for the share of testing that insurance did not pay. You may also get separate bills from others involved in the same test. Our guide to one visit with multiple bills explains why this happens.

  • Natera bill for Signatera: sent by Natera for the lab test. Natera says payment is due 30 days after the issue date on the bill.

  • EOB for the Signatera claim: an Explanation of Benefits is sent by your insurance company to show how your plan processed the claim. It is not a bill.

  • Blood draw charge: sent by the clinic, hospital, or lab that drew your blood, if it bills separately.

  • Pathology or tissue charge: sent by the hospital or lab that stored your tumor sample, if it bills for sending tissue for the first test.

  • Office visit bill: sent by your oncologist's office for the visit where the test was ordered or reviewed.

Why do I keep receiving multiple Signatera bills?

Signatera bills keep coming because Signatera is a serial test, meaning the same test is repeated over time to watch for changes. Natera's FAQ says it is generally ordered every three months, and your care team sets the schedule.

Each blood draw is processed as its own test. Each one can create its own insurance claim, its own EOB, and its own bill. A bill that arrives months after a draw may be for an older test, so match each one by date.

Which bill is this? Understanding repeat Signatera test bills

Use this list when a Signatera bill arrives and you are not sure which test it covers. Start with the date of service, the date your blood was drawn.

  • A date of service near your surgery or first tissue sample: this is likely the first test, which designs your personal test. Check that the tissue and first draw are not billed twice.

  • A date of service that matches a follow-up draw: this is likely a monitoring test. Check that an EOB exists for that date.

  • Two bills with the same date of service: this may be a duplicate or a corrected bill. Ask Natera which one replaces the other before you pay.

  • A bill with no matching EOB: the claim may still be in process, or it may never have been sent. Ask your insurer whether it received a claim.

  • A date when you do not remember a draw: this may be a redraw, a wrong date, or an error. Ask Natera which sample the charge is for.

  • A bill much higher than earlier ones: this may come from a denial, a new plan, or a deductible that reset. Check the reason codes on the matching EOB.

Common errors on Signatera bills

Signatera bills may have the same errors as other lab bills, and repeat testing gives errors more chances to happen. Most medical bills have errors, so each new Signatera bill is worth checking.

  1. Duplicate charges: two bills or EOB lines with the same date of service and amount. An itemized bill lists each charge so repeats are easier to spot.

  2. Billed before insurance processed the claim: a bill with no EOB for that date.

  3. Wrong insurance on file: an old plan name or ID on the EOB after a job or plan change.

  4. Processed as out-of-network: out-of-network means no contract with your plan. Natera says it is in-network with most health plans, so ask your insurer to confirm.

  5. Prior authorization denial: the EOB says approval was needed and not received.

  6. Medical necessity denial: the reason says the test was not needed or was experimental.

  7. Financial assistance not applied: a later bill does not reflect an approval you received.

Prior Authorization Insurance Denial for Signatera Blood Test

Prior authorization is approval from your health plan that may be needed before a service is covered. Your doctor's office usually requests it. A medical necessity denial means your plan decided the test was not needed for your care. Medically necessary care is care needed to diagnose or treat a condition that meets accepted medical standards, per HealthCare.gov.

You can appeal either denial. An appeal is a formal request asking your plan to review its decision. You generally have 180 days from the denial notice to file, per HealthCare.gov's internal appeals page. If the plan still says no, you can ask for an external review by an independent reviewer, generally within 4 months of the final denial. Our guide to a prior authorization denial explains how your doctor's office can help.

What does Natera offer for Signatera billing help?

  • Financial assistance program: Natera offers financial assistance for individuals and families who qualify. Granted can check whether you qualify and help you apply.

  • Cash pay rate: Natera offers a cash pay rate for people who do not want to use insurance, and exclusions may apply.

  • Billing questions: Natera's Signatera FAQ lists 1-844-384-2996 for questions about cost. Its billing page also lists 650-489-9050 (press 2, then 4) and oncologybilling@natera.com. Support is on weekdays, Central Time.

  • Online payment: Natera lists my.natera.com/payment.

When you ask about financial assistance, ask whether an approval covers future Signatera tests, for how long, and whether you need to do anything for each new bill. Write down the answer, the date, and who you spoke with.

If you plan to pay yourself, you can ask for a good faith estimate. That's a written estimate of expected charges. Providers usually must give one to people not using insurance, per CMS. CMS is the federal agency that runs the No Surprises Act rules. If your bill comes in $400 or more over the estimate, those rules let you dispute it.

What to do if insurance denies coverage for a Signatera test

  1. Find the date of service on the bill and match it to a blood draw, using the "Which bill is this?" list.

  2. Find the EOB with the same date before you pay. Our guide to the EOB vs. medical bill shows how to line them up.

  3. Check the EOB for a denial, an out-of-network label, or a reason code. If the bill is higher than the "you owe" amount, ask Natera why.

  4. Call Natera billing if anything does not match. Ask whether insurance has finished processing, and whether the bill can be held while you sort it out.

  5. If the claim was denied, ask your oncologist's office to send your insurer the records that show you needed the test. These are usually visit notes and a letter of medical necessity from your doctor. If the plan still denies it, file an appeal by the deadline on the denial letter. Our 48-hour plan for a denied claim covers the first steps.

  6. Apply for Natera's financial assistance program if the amount is hard to pay.

  7. Keep a single log of all your tests: date of service, claim number, EOB amount, bill amount, calls, and payments.

How Granted can help you lower your Signatera bill

Our health advocates review Natera bills and know what to look for. Upload your Natera bill and take a picture of your insurance card. We match the bill to the right test and check for duplicates and other errors. If something looks wrong, we contact Natera's billing team and your insurer. If your plan denied a claim, we can review the denial and the EOB, gather records, and file an appeal with your OK. We also check your eligibility for income based discounts, and other discounts that Natera provides. When you connect your insurance, we can watch for each new claim and check that any discount you get is applied to future bills.

If you are looking at a bill like this one, upload it and get a second look before you pay. Free to start. You only pay if we lower your bill. Check your bill

For other kinds of lab bills, see our guide to lab test types, costs, and what to check.

Frequently asked questions about Signatera bills

How much does Signatera cost with insurance?

The cost of Signatera with insurance depends on your plan, your deductible, and whether the claim is approved. Natera says being in-network does not mean your plan covers 100% of the cost. Your share can change from one test to the next. A test early in your plan year may cost more, before you meet your deductible. A later test may cost less once your deductible is met.

What is the Natera Compassionate Care program for Signatera?

The Natera Compassionate Care program for Signatera is Natera's financial assistance program for people who qualify. Natera says it helps individuals and families who need help paying for testing. If you are not sure you qualify, it is worth applying.

What can I do if insurance denied my Signatera test?

If insurance denied your Signatera test, start with the denial reason on your EOB or denial letter. Your oncologist's office can send records showing why you needed the test. You can file an internal appeal, generally within 180 days. If the plan still says no, you can ask for an external review.

Who is Granted?

Granted is a digital health advocate that reviews medical bills and EOBs, finds billing errors, negotiates bills, appeals denied claims, and checks eligibility for income based discounts. We can match each Signatera bill to its test and check it before you pay. Granted is free to start. If we lower a bill, our fee is 10% of the negotiated savings, capped at $300 per bill. See how much Granted costs for the full details.

Key terms in this post

  • Signatera: a tumor-informed blood test from Natera that looks for traces of cancer DNA after treatment.

  • Circulating tumor DNA (ctDNA): small pieces of DNA that cancer cells shed into the blood.

  • Molecular residual disease (MRD): small amounts of cancer that may remain after treatment and are too small to see on a scan.

  • Serial testing: repeating the same test over time to watch for changes.

  • Explanation of benefits (EOB): the statement your insurer sends after it processes a claim; it is not a bill.

  • Prior authorization: approval from your health plan that may be needed before a service is covered.

  • Appeal: a formal request asking your health plan to review a denial.

  • Letter of medical necessity: a short letter from your doctor explaining why a test or treatment is needed for your care.

Sources & more information

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