ENCOMPASS™ BILLING GUIDE
An Explanation Of Benefits (EOB) from your health insurer is a summary, not a bill

Your insurance company will likely mail or email you an Explanation of Benefits (EOB) after we submit your claim. It's a summary of how they processed it — not a request for payment. The numbers on it are often not the numbers you'll actually owe. Check your Encompass bill for those details.

Reading a sample EOB, line by line

Service billed: Encompass™ Test

Listed under CPT code 81599 — a general lab code used because Encompass is a newer, specialized test without its own dedicated code yet. This is normal and expected.

Amount billed

This is Mirvie's list price for your insurance company — not what you owe. List price is the starting point plans use to calculate their discount and payment, similar to a hospital's list price for any lab service.

Plan paid

What your plan paid Mirvie directly. This varies by plan and whether Encompass is in-network with your specific insurer.

Patient responsibility

This is the line that alarms people most, and it's not necessarily your final bill. If your claim was processed and covered, your actual cost is based on your plan's deductible and coinsurance — which may be lower than the amount shown on the EOB. If your claim was denied, the $295 self-pay price will be applied instead of this amount. Either way, if the amount is a hardship, our Financial Assistance Program may reduce it further based on household income. Call us before paying anything you're unsure about.

Still owe more than you expected? See if you qualify for financial assistance

Based on 2026 federal poverty guidelines. This applies whether your insurance covered part of the cost, denied the claim, or you're using the self-pay price. Financial assistance can reduce what you owe, on top of whatever your plan has covered.

Qualifying for Financial Assistance
Review the estimates below and apply to confirm if you qualify.
Household size
(including the unborn baby)
$0 cost
$75 cost
$150 cost
2 person
Up to $43,280
$43,281 up to $64,920
$64,921 up to $86,560
3 person
Up to $54,640
$54,641 up to $81,960
$81,961 up to $109,280
4 person
Up to $66,000
$66,001 up to $99,000
$99,001 up to $132,000
5 person
Up to $77,360
$77,361 up to $116,040
$116,041 up to $154,720
What to do if a check shows up in your mailbox

Occasionally, an insurer pays the patient directly rather than paying Mirvie with the expectation that you will pay Mirvie. If that happens to you, here's the whole process:

  1. It's not extra money. That payment is meant for the Encompass test, not as personal reimbursement — it is owed to Mirvie, the San Francisco-based lab that provides Encompass.
  2. Send it within 10 days. Pay the same amount online, or endorse and mail the check with a copy of the EOB, to the address our billing team provides.
  3. You're done. Once received, your account is settled based on your actual claim outcome and any financial assistance applied.
  4. The insurer pays you. Your insurance company sends a reimbursement check or payment directly to you, along with an EOB.

Not sure if a check is for Encompass, or where to send it?

Don't deposit or forward anything until you check with us — call 888-850-8812 or email billing@encompasstest.com and we'll confirm exactly what to do with it.

Billing questions, answered plainly

Why does the EOB list an amount so much higher than what I expected?

That's the standard billed amount insurers use to calculate their portion — similar to a hospital's list price. If your plan covered the claim, your real cost is based on your deductible/coinsurance. If the claim was denied, the $295 self-pay price replaces that number. Call us if you're not sure which applies to you.

What if my insurance denied the claim entirely?

The $295 self-pay price applies automatically — you won't owe the full billed amount. We can also file an appeal on your behalf; just let our billing team know, and we'll send you a short authorization form.

How do I apply for financial assistance?

Email billing@encompasstest.com or call 888-850-8812 and ask for the Financial Assistance Program. It's available whether your insurance covered part of the cost, denied the claim, or you're on the self-pay price. It is based on household income and size (see table above). Your pregnancy can be counted in household size. No tax documents required for most applicants.

Can I still use my HSA or FSA to pay this?

Yes. You can pay your balance directly from an HSA or FSA, or submit your receipt to your plan administrator for reimbursement.

Can I set up a payment plan for what I owe?

Yes — payment plans are available. Contact billing to set one up; there's no interest or fee for using one.