[Histonet] RE: Pathology billing for consultation

[Weems, Joyce]

It is my understanding that we cannot charge professional fees for other pathologists. Our hospital pays for the pathologists' consults if the patient's insurance will not or if the consultant does not bill third party. 

Joyce Weems 
Pathology Manager 
Saint Joseph's Hospital 
5665 Peachtree Dunwoody Rd NE 
Atlanta, GA 30342 
678-843-7376 - Phone 
678-843-7831 - Fax 



-----Original Message-----
From: histonet-bounces <@t> lists.utsouthwestern.edu [mailto:histonet-bounces <@t> lists.utsouthwestern.edu] On Behalf Of Demarinis, Carolyn
Sent: Wednesday, September 08, 2010 09:22
To: HISTONET <@t> PATHOLOGY.SWMED.EDU
Subject: [Histonet] Pathology billing for consultation

I would like to know how other pathology labs are billing for consultations that are sent out by pathologist for second opinion.
Our process is to notify the physician's office that a case is being sent to an expert and, if required, the physician's office is responsible for obtaining precertification if the patient's insurance require it.
Unfortunately, this has caused us a number of problems.  If the consultant is not "in-network", the insurance does not cover this expense, and the patient is responsible for the bill.
Is it a better option for the hospital to receive all bills from consultants, and in turn, the hospital will bill the patient?  If so, are there problems associated with this?
Or are other laboratories having the consultants bill the patient's insurance directly, and if so, are they experiencing similar problems?
Thanks.
Carolyn DeMarinis, Pathology Supervisor
Saratoga Hospital Laboratory




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