Patients
We are a team of board certified pathologists and scientists specializing in cancer diagnosis. Visit our patient resources to learn more about our Bone Marrow Clinic program and how it works.
We are in network with most major health networks including Medicare, Medicaid, TRICARE, BCBS, Aetna, United Healthcare, Cigna, Humana, Wellmed, and others.
See our List of Accepted Insurance Plans for 2024. If you have any questions, please contact us at contact@corepath.us or 1-877-617-4445 or via our contact form.
Patient Resources
I Want to Understand …
Patients often present to their provider with high or low blood counts and symptoms that can look like those of other medical concerns (fatigue, unexplained aches or pains, fever, weight loss). Since bone marrow is where blood cells are made, examining the marrow can provide valuable information to help diagnose possible blood-related cancers and disorders. A peripheral blood sample will also be taken at the time of the aspiration and biopsy. This sample of circulating blood allows the laboratory to establish blood cell counts in real-time and can be used in other types of testing.
Leukemia, lymphoma and myeloma, among others, are blood related cancers known as hematopoietic or hematologic (of, relating to, or involved in the formation of blood cells). Breast, lung, colon and prostate are known as solid tumor cancers. Solid tumors themselves can occur almost anywhere in the body including bones, muscles and organs.
CorePath has prepared a quick guide to what you need to know before a bone marrow biopsy and aspiration procedure. Click here to download our patient guide.
CorePath offers a unique opportunity for your provider to refer you directly to our laboratory for your bone marrow aspiration and biopsy procedure. One of our interventional pathologists performs your biopsy in our state-of-the-art facility in a private Passionate Care Suite. This benefits you and your provider by:
- Delivering maximum comfort and safety through every step of the procedure
- Ensuring we have the highest quality sample for your testing
- Guaranteeing testing begins immediately – our team walks your sample into our adjacent laboratory upon completion of the procedure
Diagnostic testing, like that performed at CorePath, can play a critical role in helping your provider confirm or rule out the presence of a possible disease, or whether a condition may be benign or malignant.
CorePath specializes in analyzing blood, bone marrow, lymph node and tissue samples to determine if you may have cancer or another disorder or condition, like an infection, that can mimic the symptoms of cancer. CorePath testing can also help monitor a disease process and allow you and your provider to develop and evaluate a treatment plan.
CorePath offers different types of laboratory tests that can give your provider insights into both the cellular and genetic makeup of a possible cancer or disease. Some of these tests include:
- Morphology: Viewing how blood and tissue cells appear under a microscope.
- Immunohistochemistry and Special Stains: Using staining techniques on blood, bone marrow and tissue cells to identify proteins found in various types of cancers.
- Flow Cytometry: Passing blood, bone marrow or tissue cells single file through a series of lasers to sort, count and identify their characteristics. Flow cytometry can analyze the size and shape of cells, as well as the presence of cancer tumor markers or antigens on their surface.
- Fluorescence in situ Hybridization (FISH): Labeling chromosomes (each of us have 23 pairs) or genes with a fluorescent dye to detect a specific sequence of DNA and changes to that DNA.
- Routine Chromosome Analysis or Cytogenetics: Creating a karyotype, or a view of every one of an individual’s chromosomes in numerical order, to look for abnormalities.
- Polymerase Chain Reaction (PCR): Amplifying millions of copies of DNA to look for specific gene mutations.
- Next Generation Sequencing (NGS): Identifying differences between an individual’s genome (or the set of genetic material found in each chromosome) and that of a normal or reference genome, to pinpoint changes or genetic variants on a rapid, massive scale. The Human Genome Project, completed in 2003, established a reference genome for 99% of human DNA.
- Tumor Profiling: Tumor profiling looks for mutations or genetic changes in a tumor’s DNA and RNA that can help with an understanding of how different types of cancer may respond to treatment. Tumor profiling may look at only one tumor biomarker (a gene, protein or other substance) or multiple biomarkers.
You may also hear the term “Comprehensive Genomic Profiling (CGP)” which refers to using next generation sequencing (NGS) to analyze actionable genes that are known cancer biomarkers.Most tumor profiling tests include genes that have been recommended by the National Comprehensive Cancer Network (NCCN). The NCCN Guidelines are a sequential set of management decisions, interventions, and treatments for providers that have been extensively studied and apply to the large majority of cancers in the U.S.
Tumor profiling is a core concept in precision medicine or personalized medicine which uses a person’s genes, proteins, environment, and lifestyle to prevent, diagnose or treat a disease. The goal of precision medicine is to ensure a precise diagnosis is made so the patient gets the right drug or intervention at the right time.
Blood, bone marrow and tissue cancers can be extremely complicated diseases where a group of tests run together, or sequentially (called reflex testing), can help form a more complete picture of what your cancer is, how it is behaving, how it will respond to treatment, and how quickly it may recur, if at all.
With a 20/20 CORE Evaluation on blood, bone marrow or tissue, CorePath’s board certified pathologists leverage their extensive medical expertise to choose testing that will be most beneficial to you and your provider based on your blood and/or laboratory work, biopsy material, medical history, and clinical presentation (symptoms). This approach means that only medically necessary tests are ordered for you, results get back to your provider more quickly and you’re spared multiple blood draws or biopsies to obtain adequate samples for testing. All of your results are integrated into one report that your provider can access anytime.
A pathologist is a physician (an MD or DO) who is an expert in the diagnosis, prognosis, and treatment of disorders of body tissues and fluids. Once pathologists obtain their medical degree, they spend an additional three to four years in a pathology residency program, followed by fellowship training, often completing 11-14 years of education.
Hematopathologists are experts in diagnosing cancer and other diseases of the blood, lymph nodes and bone marrow.
Hematopathologists most frequently are involved in the diagnosis of:
- Leukemia: A cancer that begins in the bone marrow and causes large numbers of abnormal blood cells to be produced and enter the bloodstream. Leukemias can also be categorized as either “chronic” (slowing progressing) or “acute” (rapidly progressing).
- Lymphoma: A cancer that begins in the cells of the lymphatic system. This includes the bone marrow, lymph nodes, spleen and thymus. The most common forms of lymphoma are Hodgkin’s lymphoma and non-Hodgkin’s lymphoma.
- Myelodysplastic Syndrome (MDS): A form of cancer where the bone marrow doesn’t produce enough healthy blood cells (white cells, red cells, and platelets) and there are abnormal cells in the blood or bone marrow.
- Myeloproliferative Neoplasms (MPN): A type of cancer where the bone marrow makes too many red blood cells, platelets, or certain white blood cells.
- Plasma Cell Disorders (Multiple Myeloma): A form of cancer that begins in plasma cells (white blood cells that produce antibodies).
In addition, our pathologists are trained to diagnose solid tumors, such as breast, lung, colon, prostate and others.
Your provider may have ordered a liquid biopsy for several reasons, but in particular if your cancer has metastasized (spread from one part of your body to another) or your cancer treatment isn’t working. A liquid biopsy is done with a simple blood draw (noninvasive) and doesn’t require you to have another bone marrow or tissue biopsy, especially if you’re unwell or another biopsy procedure might cause complications.
This is possible because as tumors grow, pieces can break off and circulate in your bloodstream. The tumor can shed circulating tumor cells (CTCs) or release cell-free DNA and RNA (cfDNA and cfRNA). A liquid biopsy can help determine your prognosis and inform treatment decisions.
CorePath will provide your results directly to your provider. Depending on the type and number of tests your provider has ordered, they may receive results in as little as 2 days. If more comprehensive testing has been ordered, like next generation sequencing, your results may take up to 10-14 days.
Clinical trials investigate new approaches to prevent, detect or treat cancer and other diseases and whether these are safe and effective. For the most current information about trials near you, go to https://www.nih.gov/health-information/nih-clinical-research-trials-you/finding-clinical-trial. Always consult with your provider about whether a trial may be right for you and if you meet eligibility to participate in a trial.
For more information on any of the above or specific types of cancer, these resources can provide excellent information:
- American Cancer Society (ACS): https://www.cancer.org/
- International Myeloma Society: https://www.myelomasociety.org/
- MedlinePlus: https://medlineplus.gov/cancer.html
- Leukemia & Lymphoma Society: https://www.lls.org/
- National Cancer Institute (NCI): https://www.cancer.gov/resources-for/patients
- National Comprehensive Cancer Network (NCCN): https://www.nccn.org/patientresources/patient-resources
Billing Questions
The No Surprises Act protects people covered under group and individual health plans from receiving surprise medical bills when they receive most emergency services, non-emergency services from out-of-network providers at in-network facilities, and services from out-of-network air ambulance service providers. It also establishes an independent dispute resolution process for payment disputes between plans and providers, and provides new dispute resolution opportunities for uninsured and self-pay individuals when they receive a medical bill that is substantially greater than the good faith estimate they get from the provider.
In 2022 there were new protections that prevent surprise medical bills. If you have private health insurance, these new protections ban the most common types of surprise bills. If you’re uninsured or you decide not to use your health insurance for a service, under these protections, you can often get a good faith estimate of the cost of your care up front, before your visit. If you disagree with your bill, you may be able to dispute the charges. Here’s what you need to know about your new rights.
Before the No Surprises Act, if you had health insurance and received care from an out-of-network provider or an out-of-network facility, even unknowingly, your health plan may not have covered the entire out-of-network cost. This could have left you with higher costs than if you got care from an in-network provider or facility. In addition to any out-of-network cost sharing you might have owed, the out-of-network provider or facility could bill you for the difference between the billed charge and the amount your health plan paid, unless banned by state law. This is called “balance billing.” An unexpected balance bill from an out-of-network provider is also called a surprise medical bill. People with Medicare and Medicaid already have these protections and are not at risk for surprise billing.
If you get health coverage through your employer, a Health Insurance Marketplace® [1], or an individual health insurance plan you purchase directly from an insurance company, these new rules will:
- Ban surprise bills for most emergency services, even if you get them out-of-network and without approval beforehand (prior authorization).
- Ban out-of-network cost-sharing (like out-of-network coinsurance or copayments) for most emergency and some non-emergency services. You can’t be charged more than in-network cost-sharing for these services.
- Ban out-of-network charges and balance bills for certain additional services (like anesthesiology or radiology) furnished by out-of-network providers as part of a patient’s visit to an in-network facility.
- Require that health care providers and facilities give you an easy-to-understand notice explaining the applicable billing protections, who to contact if you have concerns that a provider or facility has violated the protections, and that patient consent is required to waive billing protections (i.e., you must receive notice of and consent to being balance billed by an out-of-network provider).
If you don’t have insurance or you self-pay for care, in most cases, these new rules make sure you can get a good faith estimate of how much your care will cost before you receive it.
You can dispute a medical bill if your final charges are at least $400 higher than your good faith estimate and you file your dispute claim within 120 days of the date on your bill.
Some health insurance coverage programs already have protections against surprise medical bills. If you have coverage through Medicare, Medicaid, or TRICARE, or receive care through the Indian Health Services or Veterans Health Administration, you don’t need to worry because you’re already protected against surprise medical bills from providers and facilities that participate in these programs.
Still have questions? Visit CMS.gov/nosurprises, or call the Help Desk at 1-800-985-3059 for more information. TTY users can call 1-800-985-3059.
Texas Senate Bill 989 (SB 989)
Requires health plans operating in Texas to cover evidence based, scientifically valid biomarker testing for the purpose of diagnosis, treatment, appropriate management, or ongoing monitoring of a disease or condition to guide treatment.
The biomarker testing must provide clinical utility and:
- Be evidence-based
- Be scientifically valid based on medical and scientific evidence
- Informs a patient’s outcome and a provider’s clinical decision
- Predominately address the acute or chronic issue for which the test is being ordered
In May of 2023, Texas became one of 12 states to expand access to biomarker testing.*
Biomarker testing is a type of precision medicine that can identify targeted therapies and immunotherapies to treat cancer based on an individual’s unique genetic profile. This “precision” approach helps ensure that a patient receives the right treatment at the right time for their specific cancer. Ongoing studies continue to show that biomarker testing can improve patient outcomes and survival, especially in advanced or metastatic forms of cancer.
Biomarker testing has already become part of clinical guidelines for the treatment of metastatic non-small cell lung cancer (NSCLC), metastatic breast cancer, melanoma, ovarian cancer and colorectal cancer by the National Comprehensive Cancer Network (NCCN). https://www.nccn.org/patientresources/patient-resources/guidelines-for-patients
It’s estimated that less than half of eligible Texas patients receive biomarker testing [2], preventing them from having access to new biomarker defined drugs and clinical trials. Biomarker testing can be somatic (an acquired genetic mutation) or germline (an inherited genetic mutation) and may also be referred to as molecular or genomic profiling.
CorePath offers a range of biomarker tests to physicians and their patients to stay on the leading edge of developments in precision medicine and cancer diagnosis, prognosis, treatment and monitoring.
*As of 03/2024, New York, Arizona, California, Georgia, Illinois, Kentucky, Louisiana, Maryland, New Mexico, Oklahoma, and Rhode Island have biomarker access laws.
Source: https://www.hhs.texas.gov/sites/default/files/documents/feb-2024-coas-agenda-item-4.pdf
How CorePath Financial Assistance Works
For any questions related to reports, insurance coverage or general questions, please contact us at contact@corepath.us or 1.877-617-4445 or via our contact form.
