Patient Protection Plan

Patients with a commercial insurance plan that is not contracted with Athena will benefit from the Patient Protection Plan. Under this plan, Athena will limit its charges to the patient to no more than 20% of billed charges or $500, whichever is less.

Here’s an example of how the program works.

Scenario 1
Patient does not take part in the PPP
Test Price	$4,000
Insurance company pays	$1,000
There is a BALANCE DUE of	$3,000
Due to the underpayment by the insurance company, the patient is left with a bill for $3,000.

Scenario 2
Patient does take part in the PPP
Test Price	$4,000
PPP Enrollment Amount	$500
Insurance company pays	$1,000
Remaining Balance	$2,500
The patient owes $0.00 because Athena's Patient Protection Plan protected them from having to pay the remaining balance.

Please understand that if you do not choose to participate in the Patient Protection Plan, Athena will still bill your insurance company. However, if the insurance company does not pay the full amount, you will be responsible for the balance.

Enrolling in the Patient Protection Plan
You must enroll in the program to limit your financial exposure. Once we receive your specimen you will be sent a letter with enrollment forms. These forms need to be completed and returned to us within 21 days of our receipt of your specimen. Your payment must be included with those forms. Once you’ve done that, you will never see a bill from Athena for your testing, regardless of what the insurance pays.*

The Patient Protection Plan is not available in Delaware, Florida, Maryland, Massachusetts, New Jersey, New York, Ohio, Rhode Island, and Texas. Each state bears its own individual laws by which Athena must abide. Roll over any state to view the applicable reimbursement policy for that state.

Athena recommends obtaining a pre-authorization from your insurance company if you have an HMO.

*If your insurance provider pays you directly, that payment must be forwarded to Athena immediately.