Billing
Department
Phone: (419)255-4603 /
(866)755-8855
Pathology Laboratories is capable of directly billing clients
for laboratory services performed. As an alternative, clients may
choose to have either their patients or their patients' insurance
carriers billed directly. A listing of information required to bill
the respective party is specified below. If you have any questions
regarding billing issues, please contact our Billing
Department.
Client Billing
Clients are billed monthly for services performed the previous
month. Each statement is itemized and includes the patient name,
accession number, date collected, test(s) performed, CPT code(s)
and charge(s). Payment terms are net 30 days.
Patient Billing
If you elect to have Pathology Laboratories bill your
patient, the patient name, address, phone number
and ordering physician must be clearly written on
the Test Requisition. ICD-10-CM DIAGNOSIS
CODE(S) or a narrative diagnosis must also be
submitted on each Test Requisition. Patient bills are prepared to
enable the patient to submit the statement directly to their
insurance carrier for payment or reimbursement.
Third Party Billing
Pathology Laboratories will bill third party agencies or
insurance companies directly for services performed. Patients will
be billed only for services or charges not covered in their
insurance program or contract. ICD-10-CM DIAGNOSIS
CODE(S) or a narrative diagnosis must be
submitted on each Test Requisition.
The following information is necessary to properly file
insurance claims:
- Date of Collection
- Patient's First and Last Names
- Patient Social Security Number
- Patient Sex
- Patient Date of Birth
- Patient Address
- Patient Phone Number
- ICD-10-CM DIAGNOSIS CODE
- Ordering Physician Name
- Medicare Number
- Medicaid Number
- Subscriber Name
- Subscriber Date Of Birth
- Subscriber Social Security Number
- Primary Insurance
-
- Address/Phone
- Group No./Plan Code
- Secondary Insurance
-
- Address/Phone
- Group No./Plan Code
- Advance Beneficiary Notice of Noncoverage, as appropriate. (See
instructions in the Compliance Section)
Pathology Laboratories will accept the above information in
various forms (e.g., copy of patient's insurance card(s), patient
demographic computer sheet).
CPT Coding
Correct CPT Coding is the responsibility of the billing party.
CPT codes listed in this web-site reflect PathLabs' interpretation
of the CPT code requirements only, as published in the current CPT
Coding Manual. CPT codes may change frequently and should be
periodically verified for accuracy.
PATHLABS ASSUMES NO RESPONSIBILITY FOR BILLING ERRORS
MADE BY OUTSIDE PARTIES DUE TO RELIANCE ON THE CPT CODES LISTED
HEREIN.
For further information, please consult the CPT Coding Manual
published annually by the American Medical Association.