[Histonet] RE: Is there a Law for refusal of pathology services.

[O'Donnell, Bill]

I believe the question was asking for "laws". 

A law is different than what insurance companies may or may not prefer. They have 'rules' but have to follow 'laws'. Laws that might concern this are also enacted at both the national and state levels. Any state might differ over another.  All I can offer beyond that is, if really concerned, and it sounds like you are, take up the question with your Risk Management folks, or whatever department deals with that kind of stuff. 

This case is one you are aware of. It might shock you to learn how many times patients do not have their tissues examined, especially in clinics. The best record might the op-notes, as far as the insurance companies are concerned. 

To assume the patient won't be covered, that she has anterior motive, or that the lab is the sole documentation of a procedure is to make legal assumptions and, frankly, that's not a good idea. 

All of that said - it is, in my mind, prudent to get a diagnosis, but prudence is different than necessity and patient rights are pretty broad and are rarely narrowly interpreted. 

Thanks for reading this far down -

Bill (Not A Lawyer) O'Donnell

 



-----Original Message-----
From: histonet-bounces <@t> lists.utsouthwestern.edu [mailto:histonet-bounces <@t> lists.utsouthwestern.edu] On Behalf Of Barbara Tibbs
Sent: Tuesday, August 19, 2014 8:52 AM
To: Sue; Paula Pierce
Cc: Histonet
Subject: [Histonet] RE: Is there a Law for refusal of pathology services.

Also, legally speaking, if it isn't documented, it didn't happen in the eyes of the law.

Barbara S. Tibbs
Histology Supervisor
Accurate Diagnostic Labs
South Plainfield, NJ
barbara.tibbs <@t> accuratediagnosticlabs.com
732-839-3374
Cell: 610-809-6508


________________________________________
From: histonet-bounces <@t> lists.utsouthwestern.edu <histonet-bounces <@t> lists.utsouthwestern.edu> on behalf of Sue <suetp918 <@t> comcast.net>
Sent: Monday, August 18, 2014 9:43 PM
To: Paula Pierce
Cc: Histonet
Subject: Re: [Histonet] Is there a Law for refusal of pathology services.

I agree, if you do not document that a specimen was removed most likely insurance will deny the clain.

SPaturzo
TJU
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