At Interscope Pathology one of our core values is customer service, and to further that goal we have our own, in-house, billing department to assist you with insurance claims and other billing issues. Each account representative is experienced in all phases of insurance billing and can assist you with your questions and concerns. When you call our office, please have your account number available. Privacy requirements (as dictated by the Health Information Portability and Accountability Act of 1976, “HIPAA”) require that we discuss patient billing information with only the patient, unless the patient is under the age of 18.

As a courtesy to our patients Interscope Pathology will bill all types of insurances, but it is your responsibility to know your insurance benefits as regards to your specific policy, including deductible and co-payment amounts. Questions regarding these benefits are best answered by your insurance company. Interscope Pathology has contracts with many of the major insurance companies and local medical groups. However, it is not possible for us to contract with all insurance companies and medical groups nationwide. To avoid situations where an insurance company refuses to pay a claim, it is prudent to insure that we are a contracted provider with your specific insurance company. We will be happy to assist you in determining if we are a contracted provider. Our billing department is available to take calls from 8:30 am to 4:30 pm Monday through Friday.

Billing Policy

Interscope Pathology Medical Group will submit a HCFA claim form for medical services to any insurance company when billing information is provided at the time of service. Contractually, billing time limits may apply and your claim may be denied due to “untimely claim filing”. It is in your best interest to respond to your first billing to ensure your billing information is accurate for these services. Please call the billing department if you have any questions.

Payment Policy

Payment is due upon receipt of your first bill. It is your responsibility to contact the billing department in a timely manner should you have any questions or concerns regarding your bill. We are available: Monday thru Friday, 8:30 am to 4:30 pm.

Payment options:

Cash
Personal check
MasterCard
Visa
Payment Plan is available, credit is extended for 90 days.

Professional Courtesy

The waiver of co-payments in cases of financial hardship is appropriate when the co-payment acts as a barrier to needed care. However, waiving co-payments or deductibles on a regular basis may be construed as misstating physician charges with implication for insurance fraud and abuse. The failure to regularly bill for co-payments or deductibles for a specific physician or group of physicians, or extending professional courtesy to a referring physician, may also be interpreted as an inducement for a referral and subject to civil penalties by Medicare and Medicaid. Moreover, the Health Insurance Portability and Accountability Act of 1996 (HIPAA) allows for criminal sanctions and grants the Inspector General and the Attorney General the authority to investigate fraud and abuse in claims submitted to private health plans, as well as to government programs.

The extending of professional courtesy discounts is done on a case-by-case basis when there is financial hardship.

For additional discussion, see the summary of the American Medical Association's Board of Trustees Report 18-A-98 on Professional Courtesy.

California Business and Professions Code 655.6

a) It is unlawful for any person licensed under this division or under any initiative act referred to in this division to charge, bill or otherwise solicit payment from any patient, client, customer, or third-party payer for cytologic services relating to the examination of gynecologic slides if those services were not rendered by that person or under his or her direct supervision.

b) Clinical laboratories performing cytologic examination of gynecologic slides shall directly bill either the patient or the responsible third-party payer for the cytologic services rendered by those laboratories. Clinical laboratories shall not bill the patient or surgeon who requests the tests.

c) For the purposes of this section, any person or entity who is responsible to pay for cytologic examination of gynecologic slide services provided to that patient shall be considered a responsible third-party payer.

d) This section shall not apply to any of the following:

1) Any person who, or any clinical laboratory that, contracts directly with a health care service plan licensed pursuant to
Section 1349 of the Health and Safety Code, if services are to be provided to members of the plan on a prepaid basis.

2) Any person who, or clinic that, provides cytologic examination of gynecologic slides services without charge to the patient, or on a sliding scale payment basis where the patient's charge for services is determined by the patient's ability to pay.

3) Health care programs operated by public entities, including, but not limited to, colleges and universities.

4) Health care programs operated by private educational institutions to serve the health care needs of their students.

5) Any person who, or clinic that, contracts with an employer to provide medical services to employees of the employer if the cytologic services relating to the examination of gynecologic slides are provided under the contract.

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