Frequently Asked Questions (FAQ's)
What is the California Prenatal Screening Program?
The California Prenatal Screening Program is a public health program under the Division of Genetic Disease Screening Program. The Program is working to reduce inequity in prenatal care by offering prenatal screening for certain birth defects and follow-up services to all pregnant women in California. The California Prenatal Screening Program is the largest prenatal screening program in the world.
For more information, please visit our website at https://www.cdph.ca.gov/pns
Is the test mandatory in the State of California? Will my health insurance cover this service?
Participation in the Prenatal Screening Program is voluntary and all prenatal care providers in California must offer this service to their pregnant patients. If the patient decides and consents to participate in the Prenatal Screening Program, the patient will be charged a Program fee, which may be covered by health insurance. With the exception of self-insured employers and out-of-state plans, most health insurance companies and HMOs are required to cover the fees for the Program after any deductible, co-insurance or co-pay. Medi-Cal covers the Program fee.
What is the fee for the California Prenatal Screening Program?
The current Program fee is $221.60. The fee covers the blood tests and authorized follow-up services at a State-approved Prenatal Diagnosis Center but does not cover blood draw charges and/or nuchal translucency ultrasound.
Please provide your insurance or Medi-Cal information on the test request form or send a copy of your insurance card with the specimen. If no insurance information is received with the specimen, the Program will mail a bill and insurance form to the patient. With the exception of self-insured employers and out-of-state plans, most health insurance companies and HMOs are required to cover the fees for the Program. Medi-Cal covers the Program fee.
I have already submitted my insurance or Medi-Cal information. Why am I still being billed?
These are possible reasons why you are being billed:
Your insurance or Medi-Cal information may not have been transmitted to us by your medical provider. You may provide your insurance information online at https://CDPHPaymentPortal.sutherlandglobal.com or to an agent by calling 1 (800) 597-0832.
Your insurance company did not pay your claim. Contact your insurance company if your claim was denied.
Can I pay using my credit card?
The Prenatal and Newborn Screening Programs accept Master Card (MC), Visa Card (VI), Flexible Spending Account (FSA) or Health Spending Account (HSA). You may provide your credit card information online at https://cdphpaymentportal.sutherlandglobal.com, by filling out the coupon form from your statement, or to an agent by calling 1 (800) 597-0832.
How can I get a confirmation of receipt payment?
You can log in to our online payment portal at https://cdphpaymentportal.sutherlandglobal.com or by calling 1 (800) 597-0832
Why are you billing my medical group?
Your health plan is contracted with the medical group; please contact your medical group for more information.
Is non-payment or delay of payment going to affect my credit?
The Prenatal Screening Program does not report to any credit bureaus. However, if your claim is not paid by your insurance company or if 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.
How long does it take to receive a refund?
Refunds are initiated and approved at GDSP offices. After processing the documents, the accounting office forwards the refund request to the State Controller’s Office to issue the refund check. This process can take as long as 8-10 weeks before you receive the refund check.
Are discounts for the Program available?
The Prenatal Screening test is voluntary and we do not offer discounts because the fees are established by State regulation.
My insurance paid the Program fee, why am I still receiving a bill?
We probably did not receive the payment or insurance information, and we mailed the bill directly to you or to the primary insured. We can investigate further but we will need information such as the check payment or a copy of the cancelled check if it was cashed.