New Ways to Order the Organic Acid Test with Insurance

Navigating functional lab testing during supervised CNS practice (or as a credentialed CNS) can feel overwhelming, especially when insurance comes into play. One of the labs interns ask about most often is the Organic Acids Test (OAT) from Mosaic Diagnostics (formerly Great Plains Laboratory). Because the OAT test provides deep insight into mitochondrial function, gut dysbiosis, detoxification patterns, fungal and mold exposure, and nutrient insufficiencies…it’s a staple in functional nutrition and integrative clinical work. 

Navigating ordering tests when working with clients can be difficult, especially when we have to factor in the extra cost of the test, and clients not always understanding the need or having the funds for a functional test. 

But many new practitioners aren’t sure how to order the Organic Acid Test through insurance, how the Mosaic Diagnostics insurance tiers work, or how to prepare clients for the financial component.

As a CNS supervisor, I’ve seen the same questions arise over and over again - how do we support clients’ financial status but also ensure we’re supporting their health? In this blog, I'll break down in a simple, step-by-step format to help you confidently support clients while staying within your scope of practice as an intern.

Why Insurance Knowledge Matters for CNS Interns

Even though CNS interns cannot bill insurance directly, clients frequently want to understand whether functional lab tests are covered under their existing policies. 

The Organic Acid Test is well known in integrative nutrition, but it’s also known for being costly. Depending on the client’s insurance tier and whether they work with a Mosaic in-network provider, the OAT can range from heavily discounted to fully out-of-pocket. Helping clients understand this landscape 

• improves transparency

• increases compliance

• strengthens practitioner–client trust

  
  

Let me make this clear, though…you do NOT have to accept insurance or bill insurance in your practice in order to have your clients order an Organic Acid Test through their insurance. This will largely depend on licensing laws in your state. If you can practice MNT, you can order the OAT through insurance. 

Understanding the Mosaic Diagnostics Insurance Tiers

One of the most critical pieces to understand is the insurance tier system, which determines the amount a client may pay for the OAT. These tiers help simplify an otherwise confusing billing process. Below is a breakdown you can share with clients when discussing how to order the Organic Acid Test through insurance.

Tier 1: In-Network Insurance Plans

Tier 1 typically offers the highest level of insurance coverage. These insurers have direct agreements with Mosaic Diagnostics, meaning the lab test may be billed to insurance at rates that can significantly reduce the client’s cost or make it a $0 lab test. 

Clients may expect:

• Lowest potential out-of-pocket cost

• May owe only copay, coinsurance, or deductible

• Coverage varies depending on diagnosis, medical necessity, and plan type

Always remind clients that coverage is never guaranteed.

Tier 2: Private Pay Rate with Insurance Consideration

Tier 2 insurers are not formally in-network with Mosaic, but clients may still receive a reduced self-pay rate. Mosaic occasionally submits claims for Tier 2 carriers, although reimbursement, if any, tends to be limited.

Clients may expect:

• Moderate self-pay rate

• Possible partial reimbursement

• Coverage depends heavily on diagnosis codes and plan policies

Tier 2 can create confusion, so it’s essential that interns set realistic expectations.

Tier 3: Out-of-Network or Non-Participating Plans

For insurers outside of Tiers 1 and 2, the Organic Acid Test is generally billed as self-pay. Many large insurance carriers place functional labs in this category.

Clients may expect:

• Full self-pay price

• No insurance billing

• Ability to use FSA or HSA funds

**Please note that the tier will change per region, and you should contact your Mosaic representative to get a closer look at the insurance tiers for your area. 

Why You Should Encourage Clients to Contact Their Mosaic Diagnostics Representative

While you can help clients understand the basics, only Mosaic can confirm their exact insurance coverage, so it’s crucial (and within scope) to direct clients to the right contact. Each region has a dedicated Mosaic Diagnostics representative whose job is to clarify insurance tier, whether the OAT can be billed to insurance, diagnosis code requirements, and estimated out-of-pocket cost.

You can encourage clients to say:

• “Can you confirm which tier my insurance falls under for the Organic Acid Test?”

• “What is my estimated out-of-pocket cost?”

• “Does my provider need any specific forms or codes?”

Encourage clients to contact the rep before ordering the test to avoid surprises. You can also contact the rep on their behalf. This may help you by creating a better relationship with your rep. 

Step-by-Step: How to Order the Organic Acid Test from Mosaic Diagnostics Through Insurance

Step 1: Make sure you check your individual state laws where you practice on whether or not you can order an OAT. 

Step 2: Have the client (or you) contact their Mosaic Diagnostics representative: This step ensures accurate pricing and coverage details.

Step 3: Complete the requisition form: Use diagnosis codes that are already on file with the client at their physician’s office to increase the propensity of coverage. 

Step 4: The client submits payment: Depending on their tier, clients may pay a copay, a reduced self-pay rate, or the full test price. FSA/HSA funds are often allowed.

Step 5: The client completes the collection kit: Provide clarifying instructions where needed, but the instructions included in the kit are pretty straightforward. 

Review Results: Lean on your supervisor or your network of other practitioners to help you understand the test results and how to apply them to your client. 

Communicating Cost Transparency to Clients

One of the top Google queries related to this topic is “organic acid test cost with insurance.”

Clients want clarity. Use simple, honest statements such as:

• “The cost of the Organic Acids Test varies depending on your insurance tier.”

• “Mosaic Diagnostics uses a tiered insurance system; the rep can confirm your exact pricing.”

• “In some cases, the OAT may be partially covered or discounted, but coverage is never guaranteed.”

These are transparent, ethical, and within your scope.

Final Thoughts

Ordering the Organic Acid Test through insurance becomes simple once you understand the insurance tiers, the role of the regional representative, and the proper workflow. 

Knowing this process and guiding clients through it can help increase trust within your practitioner-client relationship.