Payment and Billing: Frequently Asked Questions
What is the California Newborn Screening Program?
The
California Newborn Screening (NBS) Program is a part of the
Genetic Disease Screening Program. The NBS Program checks all babies for over 80 serious but treatable genetic disorders.
Newborn screening identifies if there is an increased chance your newborn has one of the disorders screened for. Testing is needed to tell whether your newborn actually has the disorder.
The goal of the NBS Program is to identify babies with disorders early so that treatment can be started right away to improve the health of the baby. California law requires that all babies be screened soon after birth.
āDoes Medi-Cal or private insurance cover program fees?
Medi-Cal and most other insurance companies cover the NBS Program about 99% of the time.
If your baby was born in a hospital and a blood sample was taken there, the cost is usually included in the hospital bill. If your baby was born at home, you will receive a notice from the NBS Program asking for insurance information. As a courtesy, CDPH will bill your insurance for you.
California law prevents insurance companies from refusing to issue or canceling a policy, or charging a higher rate or premium based on a personās genetic characteristics, including being diagnosed with one of the diseases found by newborn screening. It is also illegal to refuse employment based on the results of a genetic test. If you have problems with your insurance, contact 1-800-927-HELP (1-800-927-4357) or if you have a prepaid health plan, contact 1-888-HMO-2219 (1-888-466-2219).
What is the cost of the newborn screening test?
The cost is subject to change. It is $225.00 as of July 1, 2024. Please check with your doctor or the hospital for the current cost of the test.
āI have already submitted my insurance or Medi-Cal information. Why am I still being billed?
There are a few possible reasons why you are being billed. Your insurance or Medi-Cal information may not have been given to the NBS Program by your provider. In this case, you may provide your insurance
information online or to an agent by calling 1 (800) 597-0832. It is also possible that your insurance company did not pay your claim. Contact your insurance company to find out if your claim was denied.
Can I pay using my credit card?
Yes, the NBS Program accepts Master Card (MC), Visa Card (VI), Flexible Spending Account (FSA) or Health Spending Account (HSA). For homebirths babies, you may provide your credit card
information online or by filling out the coupon form from your statement or with an agent by calling 1 (800) 597-0832. For providers and hospitals, please provide your credit card information to an agent by calling (279) 667-1646.
How can I get a confirmation of receipt payment?
For homebirths babies, you can get confirmation by
logging in to our online payment portal or by calling 1 (800) 597-0832. For providers and hospitals, you can request copy of receipt payment by calling (279) 667-1646.
Why are you billing my medical group?
Your health plan is contracted with the medical group.
Is nonpayment or delay of payment going to affect my credit?
The NBS Program does not report to any credit bureaus. For homebirths babies, if your claim is not paid by your insurance company or state Medi-Cal denied the claim due to non-eligibility, you may be referred to the Franchise Tax Board for collection and your income tax return may be garnished for the amount of money that you owe. For hospitals and providers, if your statement is not paid within 90 days, your account may be referred to Medi-Cal for offset and your Med-Cal income may be reduced by the amount of money that you owe.
How long does it take to receive a refund?
The refund gets initiated and approved at the NBS Program office. After processing the documents, the Sacramento accounting office forwards the refund request to the State Controllerās Office to issue the check. This process can take as long as 8ā10 weeks before you receive the refund check.
Are discounts available?
No. newborn screening is required by the state. The NBS Program is not able to accept amounts lower than the regulated fee. The fees are established by state regulation.
My insurance paid. Why am I still receiving a bill?
The NBS Program probably did not receive the payment or insurance mailed the check directly to you or to the primary insured. The NBS Program needs information on the check payment or a copy of the cancelled check if it was cashed. Please
contact the program at gdspar@cdph.ca.gov.