Billing Options
Part of providing the best medical laboratory services includes USC Endocrine Services Laboratory’s ability to handle our clients’ concerns regarding billing. The following information is intended to alleviate our clients’ concerns as well as to further explain the needed information in ensuring that the billing process goes smoothly and accurately.
Several billing options are available to our clients. Our clients may select either doctor/client billing (billing to a healthcare provider, group practice), direct patient billing to a home address, or third party billing (billing to insurance companies, HMO, independent practice associations).
CLIENT BILLING
An itemized statement will be mailed to our clients monthly. The statement will include the patient’s name, test(s) performed and the dates of service. Payment is due upon receipt. USC Endocrine Services Laboratory request that clients notify the Billing Department within 5 days of receipt of any errors to prevent delays in adjustments. It is important to include the client’s account number on all correspondence and payments. Alternatively, please include the remittance copy of the invoice when making payments.
PATIENT BILLING
For this option, it is extremely important that the correct name, SSN, ICD-10 code(s), current mailing address, and day and evening phone numbers be printed clearly on the requisition form. Providing this information will avoid time-consuming follow-up with the client’s office from the USC Endocrine Billing Department. The invoice that the patient receives may be used for obtaining reimbursement from their insurance carriers. USC Endocrine Services Laboratory asks that the client inform the patient that he/she will be receiving a separate bill from the laboratory.
INSURANCE BILLING
As a courtesy to our clients and patients, USC Endocrine Services Laboratory will bill the patient’s insurance carrier through an outside billing agency. The carriers include commercial insurance companies, HMO’s and other managed care programs. In addition to the information needed for the patient billing option, it is very important that the subscriber/responsible party’s name and SS# be printed accurately. In order to ensure accuracy, please attach a photocopy of the front and back of the patient’s insurance identification card. The patient will be responsible for non-covered services and deductibles depending on the type of coverage. It is the patient’s responsibility to collect funds from their insurance company. Please note that the patient will continue to get a bill from USC Endocrine Services Laboratory for as long as the insurance carriers do not settle the claim. USC Endocrine Services Laboratory requests that clients remind patients to assist in this process by contacting their insurance carriers.
MEDICARE/MEDI-CAL
USC Endocrine Laboratory Services will bill Medicare and Medi-Cal for all covered services. A photocopy of the front and back of the Medicare card and/or the current Medi-Cal plastic identification card or eligibility verification slip must be attached to the requisition form to facilitate billing.
The patient’s signature will be required for all services that may not be covered by both of these government agencies on an Advance Beneficiary Notice (ABN) form. WE DO NOT ACCEPT OUT OF STATE MEDICAID.
ICD-10 (DIAGNOSIS CODE)
Most insurance carriers require a written diagnosis or ICD-10 code(s) before claims are processed. In order to avoid delays in submitting/processing claims, it is critical that the most appropriate diagnosis/ICD-10 code be printed on the requisition form. Incomplete or erroneous diagnoses or diagnoses associated with annual or routine physical examinations may result in services not covered by the Medicare program. Likewise, almost all insurance companies will not pay for claims without diagnosis / ICD-10 codes. Again, as with any other insurance billing, the patient is ultimately responsible for services provided.
PROFESSIONAL COURTESY POLICY
On October 13, 1994, the Office of Inspector General of the United States Department of Health and Human Services issued a Fraud Alert. This document states that the “…provision of free or discounted laboratory testing for health care providers, their families, and their employees…” is in violation of the Medicare/Medicaid anti-kickback statute.
USC Endocrine Laboratory Services DOES NOT provide “free or discounted testings” to our clients, their families, or their employees.