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Aegis is a clinical team who partner with physicians and labs that process patient tests. Doctors request consultations (a review) of test results from Aegis pharmacists and molecular pathologists. Our pharmacists review a patient’s lab results, medications, and care history to recommend the best treatment for a patient. Aegis pathologists confirm the pharmacist analysis. The treating doctor receives specific treatment recommendations from Aegis.
PCR (polymerase chain reaction) is a molecular test that identifies specific causes of infection in a sample (e.g., urine, saliva, blood, wound). It tells a doctor exactly what bacteria, virus, or fungus is causing the infection. It is faster and more precise than a standard culture, which means a medical provider can prescribe a targeted treatment for the individual.
PGx testing shows how a person processes certain medications. Some individuals metabolize drugs faster than expected and some slower. If a patient is on an SSRI, blood thinner, statin, or another drug with known genetic variability, a PGx test can tell a doctor if dosing is right, if a different medication would work better, or if there is a risk of side effects due to a patient’s genetics.
A PGx test tells your doctor whether a medication a patient is taking (or is about to start) is a good match for their genetics. The test looks at how a person processes specific drugs. Guidelines often suggest one or two first-line medications for a medical problem (e.g., treating high blood pressure). While those medications might work well for most patients, your genetics might show us that those drugs won’t work for you at all, or worse that you might be at increased risk for side effects from them.
Aegis reviews the results and sends the ordering physician specific treatment recommendations based on a patient’s genetics, medication list, and medical history. This allows the doctor to prescribe the medication that is right for an individual; not the medication that is right for most other patients.
Your provider requested a clinical consultation from our team as part of your care. We billed insurance for that service. If your plan includes a copay, coinsurance, or deductible, that amount is billed to you. This works the same way as any other specialist consultation.
Your bill reflects the work we did for you by reviewing your chart, evaluating your medications, checking for drug interactions, writing treatment recommendations, and generating documentation for your provider.
In most cases, yes. Aegis bills your insurance company directly. If your plan has a copay, coinsurance, or deductible, that is the amount billed to you. If you have questions about your specific coverage, the phone number on the back of your insurance card is the best resource.
You probably won’t hear from Aegis directly. Our report goes to your doctor, who decides what to do with the recommendations. If something needs to change in your treatment, your provider’s office will contact you. The one thing you may see from us is a bill if your insurance plan has a cost-share.
Other molecular test results get processed by a software program. An Aegis clinician review means one of our pharmacists pulled your chart, reviewed your medications and diagnoses, checked for any bad drug interactions, and wrote a treatment recommendation specific to your care. Then a licensed pathologist double checked it and sent the information back to your doctor.
Yes. Your doctor or a member of their staff requested the consultation. Aegis only reviews results when specifically asked to do so.
Pay online through our payment portal: Pay Bill Online. If you have questions about your bill, email: gethelp@aegishealth.com. Typically, we respond within one business day.
When a provider orders a PCR test for an infection (Wound, UTI, Respiratory, Women’s Health, STI, GI, or Fungal panel-specific) and requests an Aegis consultation, our board-certified Infectious Disease pharmacist reviews the results against the patient’s medications and history. They help explain and interpret the genetic findings and write antibiotic treatment recommendations: which antibiotic targets the cause of the infection, which to avoid based on the patient’s other drugs, and what to monitor. Results come back in under two hours in most cases.
There is no charge to providers for using Aegis services. Aegis bills the patient’s insurance carrier directly using pathology consultation codes or principal care management codes, specific to the services rendered.
Aegis clinicians review around the clock. Infectious disease PCR with antibiotic streamlining are returned in 2 hours, often faster. PGx and polypharmacy reviews are returned in 1-2 business days, but frequently the same day.
When you order a PGx test and request an Aegis consultation, our clinical pharmacist reviews the test results against your patient’s record: active medications, diagnoses, metabolizer status, and care history. They check for drug-gene interactions, flag contraindications, and write specific medication selection and dosing guidance. Our supervising pathologist reviews and approves the report. You receive a clinical narrative that you can easily digest and utilize to make the best clinical decision for your patient.
You submit a PDF of the patient’s chart with active diagnoses, medications, labs, and relevant clinical notes through your lab’s Aegis portal. You include patient insurance information, a comment requesting the review, and an attestation that the patient has been informed. Your lab will walk you through the process if you haven’t used it before.
Every Aegis consultation includes a clinical narrative explaining what the test found and what it means for the specific patient, drug interaction analysis across all active medications, dosing guidance based on metabolizer status and comorbidities, treatment recommendations (what to prescribe, what to avoid, and why), and medical necessity documentation for compliance.
Aegis bills your plan directly under pathology consultation codes CPT 80503 through 80506 or principal care management (PCM) codes. The pathology consultation codes are not common, because few pathologists specialize in molecular test interpretation. The codes, services, and billing methodology are all standard and AMA-recognized.
When a physician has precise, patient-specific drug selection guidance before writing the prescription, they get the treatment right the first time. This reduces the trial-and-error cycle that drives follow-up visits, adverse drug events, ER utilization, and hospital readmissions. Aegis consultations cost a fraction of any one of those downstream events.
Medical necessity documentation proves a test was clinically justified, the consultation was warranted, and the treatment recommendations were individualized. Aegis generates data to support this documentation during consultations. It provides audit-ready proof for your claims team.
Medication-related problems are a significant driver of hospital readmissions. PGx testing identifies patients who metabolize specific drugs too fast or too slow, which means standard dosing may not work or may cause adverse effects. When a clinician reviews the PGx results against the patient’s full medication list and adjusts the treatment plan accordingly, the risk of a medication-related readmission decreases.
Aegis consultations support HEDIS measures, Star ratings, gap-in-care closure, and risk adjustment documentation. For carriers managing Medicare Advantage plans, the clinical data from Aegis consultations contributes to the quality metrics that drive bonus payments.
When a physician orders a molecular test through your lab and requests an Aegis consultation, our team reviews the results against the patient’s full chart. A clinical pharmacist analyzes medications, diagnoses, and care history, checks for interactions, and writes specific treatment recommendations. A pathologist approves the report. It returns to the ordering physician through your existing workflow. Your lab doesn’t manage any part of the Aegis clinical review.
You’re probably paying an algorithmic service $15-$25 per test to generate a ranked drug list from your molecular results. Aegis replaces that with a clinician review: a pharmacist reviews the patient’s full chart, checks for interactions, and writes specific recommendations. A pathologist approves the report. We bill the carrier. Your per-test cost goes to zero.
Yes. Aegis replaces your per-test algorithmic interpretation cost. We bill the patient’s insurance carrier for our clinical consultation using standard pathology codes. Your lab has no financial relationship with Aegis.
Aegis bills the patient’s insurance carrier directly using clinical pathology consultation or principal care management codes, as appropriate. We have no financial relationship with your lab. Your lab does not pay us for Aegis clinician support. If a patient has a copay or deductible, that goes to the patient.
The FDA is moving toward requiring clinician involvement in test interpretation. Labs using software-only services carry that compliance exposure. Aegis’s clinician-reviewed model already aligns with the direction regulators are heading.
Low-volume labs can be can submit cases through the portal within days. Higher-volume HL7 or API connectivity takes longer, but our team manages the setup. You don’t need technical staff on your end.
The Aegis case portal is available for labs sending a lower volume of cases for clinical overreads. This requires no technical setup. For labs with more volume, Aegis can connect using HL7 or API protocols. Aegis technical teams will create and maintain the connections.
No. Your reps still sell the test. The difference is the result comes back with a clinician-reviewed report. Aegis provides a value-added service: better results for the provider and no cost to the lab.
Every consultation generates medical necessity documentation. That protects your lab. Algorithmic services can’t produce it because they’re not clinical practices. Aegis generates this documentation automatically for every case.
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