Billing Policies

Last updated: September 1, 2026

These Billing Policies summarize certain billing, payment, deposit, insurance, claim-submission, and financial-responsibility practices of RSM Diagnostics Lab LLC, a Delaware limited liability company (“RSM,” “we,” “us,” or “our”). They are general informational policies only and do not by themselves create a billing arrangement, financial obligation, price, coverage determination, claim-submission obligation, service obligation, or contractual right for any particular test, order, account, patient, provider, practice, facility, payor, or billing arrangement. They should be read together with, but do not replace or modify, RSM’s Terms of Service, Privacy Policy, applicable account agreements, order-specific documents, patient financial-responsibility forms, Advance Beneficiary Notices of Noncoverage, test requisition forms, and RSM’s Notice of Privacy Practices.

This page is a public summary only. It does not replace, modify, or supersede any signed patient financial-responsibility form, test requisition form, Advance Beneficiary Notice of Noncoverage, account agreement, payment authorization, or other order-specific document. Applicable law and mandatory program requirements control over all RSM documents. Subject to that rule, if there is a conflict among documents, the numbered document hierarchy in the Terms of Service controls. RSM’s posted billing policies rank below those Terms and above general website content for billing, payment, deposit, insurance, and financial-responsibility subjects only. Nothing on this page modifies a signed account agreement or an order-specific document except as permitted by that document or applicable law.

Standard retail pricing

Where RSM publishes or quotes standard retail pricing for a test, that pricing is established by RSM in its sole discretion, may change at any time with or without notice, and does not create any entitlement to future pricing, discounts, write-offs, or similar treatment for any other test, order, patient, payor, account, or period. Final charges, if any, are governed by applicable law and the controlling signed account agreement, patient financial-responsibility form, payment authorization, order-specific document, and Terms of Service.

Billing models

RSM may handle billing, collections, or claim submission for some orders and accounts. In other arrangements, including clinic billing approved by RSM for a specific account and subject to the clinic-billing restrictions in the Terms of Service and applicable law, a clinic, practice, or facility may bill patients or responsible parties and RSM may invoice that entity. The billing sections of the Terms of Service that address deposits, Medicare, courtesy filing, payment at submission, superbills, and excluded plan types apply only where RSM handles billing, collections, or claim submission for the test at issue unless RSM expressly agrees otherwise in a written agreement signed by an authorized RSM representative.

No duty to bill, submit, correct, appeal, or pursue claims

RSM may, but is not obligated to, submit, resubmit, correct, appeal, negotiate, arbitrate, follow up on, or otherwise pursue a claim with any payor, plan, program, administrator, or other third party. Any claim submission, inquiry, estimate, eligibility check, coverage statement, benefit information, prior authorization information, explanation of benefits, or communication concerning payment is provided for informational or administrative purposes only and does not guarantee coverage, reimbursement, payment, network status, benefit eligibility, patient responsibility, or claim outcome.

RSM may decline, delay, suspend, limit, condition, or discontinue claim activity or billing support for any order, patient, account, payor, plan, test, jurisdiction, documentation issue, compliance concern, or operational reason, to the fullest extent permitted by applicable law.

Medicare

For select tests only, and only where RSM handles billing for the order, Medicare may be accepted where RSM determines that the test, the order, supporting documentation, and the applicable jurisdiction support submission. Medicare acceptance is discretionary, may change at any time, and does not guarantee claim acceptance, coverage, or payment. Acceptance of Medicare for one test or order does not extend to any other test or order.

For covered clinical diagnostic laboratory tests paid under applicable Medicare rules, beneficiaries generally do not have Medicare cost-sharing for the laboratory service. That treatment reflects applicable Medicare payment rules and is not a representation that every test is covered, that RSM is a participating provider for every purpose, or that RSM may bill a patient any balance contrary to applicable Medicare rules. Where a Medicare test is expected to be non-covered, an Advance Beneficiary Notice of Noncoverage may be required and governs patient financial responsibility to the extent permitted by law.

Deposits and payment timing

Where RSM requires a deposit or payment at submission, the amount, timing, method, refundability, application, and treatment of the deposit or payment are governed by the applicable payment authorization, patient financial-responsibility form, account agreement, or other order-specific document, as supplemented by these Billing Policies and the Terms of Service. A deposit or payment does not guarantee coverage, claim submission, testing, or report release except to the extent required by applicable law.

Insurance, courtesy filing, and superbills

Where RSM offers courtesy commercial claim submission, it is discretionary, does not make RSM in-network, and does not guarantee payment. Where RSM does not submit a claim or a claim is denied, the patient or responsible party may remain financially responsible to the fullest extent permitted by applicable law and the governing order-specific documents. Superbill or receipt requests are handled as described in the Terms of Service.

Patient and responsible-party financial responsibility

To the fullest extent permitted by applicable law and the applicable patient financial-responsibility form, order-specific document, or payment authorization, the patient, responsible party, ordering practice, provider, facility, or other party identified by RSM remains responsible for amounts due for testing, shipping, kit handling, collection, cancellation, processing, administrative services, or other charges associated with the applicable order that are not paid by a payor, plan, program, or other third party.

Payment by a payor, plan, program, or third party does not discharge any remaining balance unless RSM expressly agrees otherwise in a written agreement, settlement, account adjustment, credit memorandum, payment record, or other written document issued or approved by an authorized RSM representative. RSM may seek payment, use lawful collection methods, suspend future services, require prepayment or a deposit, or pursue other rights available under applicable law and the governing documents. Nothing on this page substitutes for a properly signed patient financial-responsibility form or other order-specific authorization.

Good faith estimates

Where required by applicable law, RSM will provide a good faith estimate of expected charges to an uninsured or self-pay individual in connection with requested or scheduled testing. An estimate is based on information available when it is prepared and is not a guarantee of final charges, coverage, reimbursement, test availability, medical necessity, claim submission, payment, or service performance. Actual charges may differ where the order, test selection, specimen, documentation, patient status, payor information, billing arrangement, legal requirement, or other relevant circumstance changes.

Nothing in these Billing Policies limits a right or remedy that applicable law provides in connection with a good faith estimate.

Collections, returned payments, and administrative charges

To the fullest extent permitted by applicable law and the governing payment authorization, patient financial-responsibility form, account agreement, or order-specific document, RSM may charge or recover reasonable costs associated with returned payments, chargebacks, payment reversals, collection activity, third-party collection services, legal proceedings, and enforcement of amounts due. RSM may apply payments, credits, deposits, adjustments, and refunds in the manner permitted by applicable law and the governing documents.

RSM may suspend or decline future orders, shipments, account access, billing support, or services where an account, patient, responsible party, practice, provider, or facility has an unpaid balance, disputed payment, returned payment, chargeback, incomplete payment authorization, or payment-related compliance concern. Any fee described on this page must also be authorized in the applicable signed patient financial-responsibility form, payment authorization, account agreement, or other governing document before RSM may charge it.

Medicaid, HMO, and other excluded plans

Unless RSM expressly agrees otherwise in a written agreement signed by an authorized RSM representative, RSM does not bill, submit claims to, accept assignment from, or accept payment from Medicaid programs, managed Medicaid plans, HMO plans, or any other plan or payor category that RSM has designated as unavailable for the applicable test, order, patient, account, jurisdiction, or billing arrangement. RSM may decline, suspend, or restrict an order associated with an unavailable plan or payor category and may require another lawful billing arrangement before accepting or performing testing.

No guarantees

Information on this page is provided for general informational purposes only and may be incomplete, delayed, inaccurate, or out of date. RSM does not warrant coverage, reimbursement, claim acceptance, payment amount, network status, or continued availability of any billing practice, price, deposit requirement, or plan-type acceptance described here or elsewhere on the website.

Changes

RSM may revise, replace, supplement, suspend, or withdraw these Billing Policies prospectively from time to time in its sole discretion, to the fullest extent permitted by applicable law. The “Last updated” date identifies the effective version posted on this page. Continued use of the website or related services after conspicuous posting of a revised version may constitute acceptance of that revision only to the extent permitted by applicable law.

Contact

Billing questions may be sent to info@rsmdiagnosticslab.com or RSM Diagnostics Lab LLC, 2500 Grubb Rd, Suite 120, Wilmington, DE 19810.