[Histonet] RE: Pathology billing for consultation

[Jessica.Vacca <@t> HCAhealthcare.com]

We send to reference lab (with which we have a contract, if they do not have the pathologist that covers that specialty or need to then send it for additional consult outside of them, they will incur the cost and only charge for the initial consult) and it is always 3rd party billed, this will cover medicare and insurance. It's never billed back to us unless we mistakenly mark the req. incorrectly. Most of the larger reference labs take all insurances.

Jessica Vacca
Histology Supervisor
Brandon Regional Hospital
813-571-6410

-----Original Message-----
From: histonet-bounces <@t> lists.utsouthwestern.edu [mailto:histonet-bounces <@t> lists.utsouthwestern.edu] On Behalf Of Mahoney,Janice A
Sent: Wednesday, September 08, 2010 11:37 AM
To: 'Weems, Joyce'; Demarinis, Carolyn; HISTONET <@t> PATHOLOGY.SWMED.EDU
Subject: [Histonet] RE: Pathology billing for consultation

If our Pathologists need a second opinion we eat the charge.  If it is requested by the clinician, we request that he/she be billed.   If it is the patient we bill the patient (or ask the consultant to bill the patient)  All of this depends on patient status/medicare etc.
I'm very interested in seeing how others respond.
Jan Mahoney
Omaha

-----Original Message-----
From: histonet-bounces <@t> lists.utsouthwestern.edu [mailto:histonet-bounces <@t> lists.utsouthwestern.edu] On Behalf Of Weems, Joyce
Sent: Wednesday, September 08, 2010 9:46 AM
To: Demarinis, Carolyn; HISTONET <@t> PATHOLOGY.SWMED.EDU
Subject: [Histonet] RE: Pathology billing for consultation

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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