[Histonet] Pathology billing for consultation

[Rathborne, Toni]

If the request was made by the patient or their physician, then the patient is billed. They are informed of this by their physician after he/she contacts us.  If it is requested by the pathologist because they are unsure of a diagnosis, then the pathologist will pay. I'm not referring to sending out the block or slide for testing that is not done at our facility, only cases where all relevant testing has been completed and the pathologist is still uncertain.

-----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 9:22 AM
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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