[Histonet] Pathology billing for consultation

[Feher, Stephen]

There are a couple of ways to handle this and most of them have already
been mentioned.  We have a contract Pathology group in our hospital so
if the patient insurance does not pay, the consultant bills the
Pathology Group.  Unless your pathologists are completely sold on their
expert consultants, outside labs such as Genzyme will do the third party
billing if you use their consultants.  I know that they accept insurance
assignment and have relationships with most large insurers so the
patient rarely gets stuck with a bill. 


Steve

-----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




This e-mail communication and any attachments may contain confidential
and privileged information for the use of the designated recipients
named above.
If you are not the intended recipient, you are hereby notified that you
have received this communication in error and that any review,
disclosure, dissemination, distribution or copying of it or its contents
is prohibited. If you have received this communication in error, please
notify Saratoga Hospital immediately by e-mail at
privacy <@t> saratogacare.org and destroy all copies of this communication
and any attachments.


_______________________________________________
Histonet mailing list
Histonet <@t> lists.utsouthwestern.edu
http://lists.utsouthwestern.edu/mailman/listinfo/histonet