— NPV3 - Billing

Billing Information

We're going to ask you some questions around how you want to cover the cost of the test.
Patient name*

First NameLast Name
Patient date of birth*

MonthDayYear
Date
Healthcare provider name*

First NameLast Name
What is your preferred payment method?*

InsuranceSelf-pay ($295)
To ensure transparency, Tempus performs a benefits check and contacts you if we expect your out-of-pocket cost to be more than $295.
We accept all credit and debit cards as well as HSA and FSA to pay for testing.
Insurance Information
Insurance type

Commercial insurance (e.g. BCBS, Aetna, etc)Government insurance (e.g. Medicare, Medicaid)
Upload a photo of your insurance card*

Cancelof
I'd prefer to enter this information manually
Primary insurance
Policy #
Group #
Policy holder name
Policy holder DOB

MonthDayYear
Date
Relationship to policy holder

SelfSpouseChildOther
Drive Link
https://drive.google.com/drive/folders/1pHYAzOmuftm9MQpb9oxICQBwk_NQS8cj?usp=sharing
Email
example@example.com
Should be Empty:

Billing Information