Insurance Overview - Great Plains Laboratory

Insurance Overview
Blue Cross Blue Shield
Contracted Plans
BCBS of Illinois
BCBS of Kansas City PPO
BCBS of Minnesota
BCBS of Vermont
Blue Cross of Idaho PPO
Federal Employee
Blue Shield of California*
*Blue Shield Covered
Highmark Blue Shield of
California and plans that
begin with ID# “XEK” are
Non-Contracted Plans, see
guidelines below.
Insurance Providers
Carefirst BCBS – includes
Maryland, Washington
DC, and parts of
Northern Virginia
BCBS of Illinois: Comprehensive Stool
Analysis not covered*
Capital Blue Cross, Highmark, and Blue
Shield of California: IgG Food Allergy Test
w/ Candida not covered*
Keystone Health Plan
West - Pennsylvania
Highmark West Virginia
Capital Blue Cross
of Pennsylvania
*These tests must be paid in full at the time of Service
Tricare Prime
Tricare Standard
Tricare for Life
Medicare Advantage PPO
Tests not covered: Microbial Organic Acids
Test, Porphyrins Profile, Kryptopyrrole Test,
Comprehensive Fatty Acids Test. Hormones
Panels cannot be billed for Tricare South
Medicare Advantage HMO
For non-eligible tests, refer to the Advance
Beneficiary Notice (ABN) included in the
Test Requisition Form
Medicare/Medicare Advantage does not pay for tests for which the documentation, including the
patient record, does not support that the tests were reasonable or necessary, and does not cover
routine screening tests. It is the responsibility of the ordering physician to document and maintain the
medical necessity of each test in the patient’s medical record.
Comprehensive Stool Analysis requires payment of $94.44
Signed ABN required (see Test Requisition Form)
Non-contracted Blue Cross
Blue Shield (BCBS)
Anthem Blue Cross of
Blue Cross of
Massachusetts HMO
Harvard Pilgrim
United Healthcare
All Non-Contracted plans will require a 20% down
payment (see price list)
Any restricted plans or tests must pay in full at the time
of service
Contracted Insurance Providers and NonCovered Plans
IgG Food Allergy Test not covered for:
Anthem BCBS of California
BCBS of North Carolina
The Great Plains Laboratory files the insurance claim on behalf of the patient. Some insurance
companies provide payment and Explanation of Benefits (EOB) to the patients directly. If the patient is
paid directly, the endorsed check and EOB must be forwarded to The Great Plains Laboratory (endorse
back of check: ‘‘Pay to the order of The Great Plains Laboratory’’ and sign).
Non-Covered Tests
Amino Acids Plasma or Urine Test
Non-Covered Plans
We are not in-network with any of these plans and will not bill to these insurance carriers.
Full cash price payment required and must be submitted with specimens. A receipt will be sent to the patient.
Wellmark BCBS of Iowa
Wellmark BCBS of South Dakota
All non-eligible plans (see above)
Silver Direct Access (a plan under
BCBS Florida
Anthem Blue Cross of California)
HMO plans (except those listed
United Healthcare of the River Valley
Kryptopyrrole Test
DNA Methylation Pathway Profile
For any questions regarding insurance coverage, please call 913-341-8949 or 913-754-0459
Always call your insurance provider to confirm benefits as insurance coverage is subject to change. Patients are responsible for any
deductibles, copayments, cost shares, coinsurance, or balance. If for any reason your insurance company deems your lab work as a noncovered or medically unnecessary service, you will be responsible for the full amount of the charge.
We are currently applying for in-network coverage with several individual BCBS state programs. Please check our website for updated
information at Also available at this location is our insurance coverage verification guide to assist in
determining coverage.
NOTE: Insurance is filed in the state where the referring physician’s NPI is registered, or where the referring physician's NPI is currently located.