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-9-CM DIAGNOSIS CODES 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-9-CM DIAGNOSIS CODES 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-9-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.