Why am I receiving a bill for my patients? I do not pay their bills.
If the order form specifies to bill insurance or the patient, and you receive the bill, it may be for several reasons:
- We are missing crucial information about the patient and have tried soliciting this information through other forms of communication unsuccessfully (DX information, etc).
- We did not receive a signed ABN on the patient at time of service from your office, and claim is denied.
- We did not receive correct billing information to bill accordingly (insurance information, etc).
- We did not receive all pertinent patient information to bill patient (patient’s address, etc).
Should I obtain an Advance Beneficiary Notification (ABN) on all Medicare Patients?
As a best practice, and for efficiency, it is a good idea to obtain an ABN on patients seen in your office and for whom we receive a specimen. If the patient is aware of the possibility that Medicare may deny payment for certain tests for his/her medical diagnosis, they can agree to have the tests performed with the understanding they will be responsible for the charges.
This allows us to bill Medicare using a modifier. If Medicare denies payment, the patient will receive a bill for the remaining, unpaid charges. If an ABN is not obtained, we have no choice but to bill the ordering physician.
Medicare requires a correlating diagnosis and lab tests in order for the performing labs to be reimbursed. When test are collected offsite, we must partner with the ordering client to obtain information so that we can be reimbursed for our services.
The ordering client has two options:
- Provide a correlating DX code(s).
- Provide a signed ABN because no correlating DX code is available.
Please note:
All ABNs should include tests patient is receiving (mark test box if applicable), option 1, 2, or 3 clearly marked, and patient’s signature and date of signature. We cannot accept an ABN that was signed after patient’s date of service. It MUST be signed at time of service.
Where can I obtain an ABN?
Click on forms link in the Client Services section for clinical and/or anatomical ABN. Or ask your courier service to deliver some to your facility.
Why am I being billed when all you need is DX information?
Our system flags accessions that are missing DX information on your patients. An automated fax is sent to our clients once a week requesting this information. The system makes two attempts to collect this information. After the second attempt, if we have not received this information the account is sent to the client by way of statement/invoice.
A note should be included under each patient name on the invoice for whom we need additional information. We try not to send bills to our clients unnecessarily. To avoid receiving an invoice from us for missing information, it is important to send all pertinent information to our facility with the patient or a specimen so we can bill accordingly.
Pathviewer is not working. Who do I contact?
Technology can be sensitive at times. If the system is down and you cannot log on, please contact our front office to obtain any tests results. Our staff is pleased to fax those directly to your office.
If you still cannot log on by the end of the business day, please submit your concern to nleger@thepathlab.com
I would like to submit diagnosis code information online as opposed to faxing it in. Who do I contact?
Please contact Nicole Leger at nleger@thepathlab.com or 337.312.1256
I would like to pay my client bill online. How can I do that?
Please contact Nicole Leger at nleger@thepathlab.com or 337.312.1256
My BCBS patients are signing ABNS. Why is this necessary?
BCBS has partnered with Avalon Healthcare which provides guidelines and recommendations for testing and coverage. An ABN is necessary to inform beneficiaries about potential costs that may not be covered by insurance.
