Frequently Asked Questions

FAQs

What is the AR-V7 Nucleus Detect test?

The Oncotype DX AR-V7 Nucleus Detect test is a test performed through a simple blood draw. It tests whether your tumor will respond to androgen receptor (AR)-targeted therapies, such as XTANDI® or ZYTIGA®*. With the results of this test, your doctor can more confidently recommend whether AR-targeted therapy or chemotherapy is right for you.

Who is Eligible?

The Oncotype DX AR-V7 Nucleus Detect test is an option if you have metastatic castration-resistant prostate cancer (mCRPC) and your doctor is considering androgen receptor (AR)-targeted therapies, such as XTANDI® or ZYTIGA®, for your treatment. Since most mCRPC patients become resistant to AR-targeted therapies over time, the test may be performed several times during the course of your treatment.

Am I eligible if I have already had treatment with XTANDI® or ZYTIGA®?

Yes. Patients with metastatic castration-resistant prostate cancer (mCRPC) are often given several rounds of androgen receptor (AR)-targeted therapies, such as XTANDI or ZYTIGA. Because the Oncotype DX AR-V7 Nucleus Detect test detects whether your tumor has become resistant to AR-targeted therapies, AR-V7 Nucleus Detect may be performed between each round of therapy.

What causes resistance to XTANDI® or ZYTIGA®?

Tumors can adapt (and become resistant) to androgen receptor (AR)-targeted therapies, such as XTANDI or ZYTIGA, develop AR-targeted treatments. In fact, most patients who initially respond to (AR)-targeted therapies develop acquired resistance to them over time.

What kind of treatment will I get if I am resistant to XTANDI® or ZYTIGA®?

Patients with metastatic castration-resistant prostate cancer (mCRPC) tumors that are resistant to androgen receptor-targeted therapies, such as XTANDI or ZYTIGA, are often given taxane chemotherapy. Chemotherapy can both reduce cancer-related symptoms and improve survival. Doctors give chemotherapy in cycles, with each period of treatment followed by a rest period to allow the body time to recover. Each cycle typically lasts for a few weeks.

How long will it take to get the test results of the Oncotype DX test?

Most results from the Oncotype DX AR-V7 Nucleus Detect test are available within two weeks from the date your blood sample is received by the our laboratory. The results are sent to your doctor so that he or she can discuss the results with you and answer your questions.

Is the Oncotype DX test covered by insurance?

Since insurance coverage can vary across the country, it’s a good idea to check with your insurance carrier to confirm the test is covered by your insurance.



Billing FAQs

What is the GAP?

To ensure patients can focus on their health, Exact Sciences created the Genomic Access Program (GAP), which helps eligible patients determine payment options for our tests. We work with providers, patients, and insurance companies to investigate coverage and complete any prior authorization requirements, where applicable.

How much will this test cost me/how much does the test cost?

Out-of-pocket (OOP) costs for the test, if any, are determined by the insurance company. You may have financial responsibility for a co-pay, co-insurance, deductible, or non-covered charges as determined by your insurance. We strongly encourage patients to contact their insurer when they have questions about their plan design and benefits.

How will I know if my insurance covers testing?

Coverage depends upon various factors, such as your insurance’s medical necessity criteria and benefit plan design. Your out-of-pocket costs for the test, if any, are determined by your insurance company. 

What if I don’t have any health insurance coverage?

If you don’t have insurance, our Customer Service team will help you determine your eligibility for financial assistance and explore the best options available to you.

Do I qualify for any financial assistance?

Exact Sciences offers financial assistance for eligible patients based on the Federal poverty guidelines. If eligible, both insured and uninsured patients will have no out-of-pocket costs. Click here to see if you could be eligible for testing at no cost. To complete our full financial assistance application, please see/download The FINANCIAL ASSISTANCE (FA) DISCLOSURE FORM AND APPLICATION for more information. Disclaimer: Exact Sciences may modify or terminate its Genomic Access Program (GAP) and/or financial assistance options at any time.



Do you offer payment plans?

Yes, we offer flexible payment plan options. You can sign up for a payment plan using our patient portal or by speaking to Customer Service. We also offer automatic monthly bill payment options as well.

Does Medicare cover testing?

Testing is covered by Medicare Fee for Service (FFS) for patients meeting coverage criteria. Patients who meet clinical criteria for coverage usually have zero financial responsibility. For patients who do not meet Medicare criteria, an Advanced Beneficiary Notice (ABN) is required before receiving services considered not medically necessary. In these instances, you will be responsible for the test cost should you still choose to proceed.

What do I do if my health insurance sent me a check directly?

In the event your insurance company sent you a payment to cover the testing performed by Exact Sciences, please forward the payment to us using the instructions below. If you have already cashed the check from your insurance, you can mail a personal check to us or make an electronic payment via our patient portal.

  1. Endorse the back of the check by signing your name and writing “Pay to the Order of Exact Sciences”.

  2. Mail check to:
    Exact Sciences
    PO Box 742415
    Los Angeles, CA 90074-2415

  3. Include any paperwork you received from your insurance company with your payment. Otherwise, ensure your full name, date of birth, and mailing address are enclosed so we can apply the payment to your account.
How can I pay my bill/balance?

Our convenient patient portal is an easy way to check your account balance, set up payment plans, or make recurring payments automatically. Visit My Lab Bill for more information.

How do I appeal a denial decision from my insurance?

With your consent, Exact Sciences can pursue appeals on your behalf if appeal options are available. The appeal process can take several months.

How do I provide my insurance information or updated insurance information?

Please contact Customer Service to provide this information.

I received an explanation of benefits (EOB) from my insurance, is this a bill?

You may receive multiple EOBs from your insurance. You will only receive a bill from Exact Sciences if payment is required after the claim is fully processed. Contact Customer Service with any questions.



*Xtandi® is a registered trademark of Astellas Pharma, Inc. Zytiga® is a registered trademark of Johnson and Johnson.

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