Frequently Asked Questions

 

 

My patient is “Family Pact”— Is there anything that I have to do differently?
Family Pact is a special Medi-Cal program; your staff should be trained and certified by Medi-Cal on how to handle these patients and their coverage limitations.
 
Does the doctor’s office have to provide the patient’s “chief complaint” or “reason for office visit” when submitting a non-gyn specimens even if we don’t know the diagnoses?
Yes. From the General Coding Guidelines, AMA 2005 ICD-10-CM: “Codes that describe symptoms and signs, as opposed to diagnoses, are acceptable for reporting purposes when a related definitive diagnosis has not been established (confirmed) by the physician.” This information is necessary for the laboratory to properly file a claim with your patient’s insurance.
 
Do we have to fill in the patient’s address and insurance information on every requisition? We heard that the laboratory maintains a database file of previous patients’ billing information.
Yes. Submitting the patient’s correct and current address and insurance information helps both the laboratory and the patient. The laboratory can properly file a claim with the patient’s insurance, which in turn will save the patient from receiving unnecessary billing and paperwork. Because many patients will change insurance during the year, the laboratory does not maintain a database file on patient's previous billing information. You may attach demographics and billing profiles from your EMR.
 
Do we have to include the ICD-10 Code on the Gyn Cytology Requisition?
Yes. From an insurance perspective, the Pap test is either a screening Pap test (patient is asymptomatic) or a diagnostic Pap test (gynecologic signs, symptoms, or abnormal history). Patients undergoing screening Pap tests can be further divided into low-risk and high-risk patients. The medical necessity ICD-10 Code conveys these distinctions, and, depending on the insurance coverage benefits, ICD-10 coding will impact payment for the Pap test.
 
Is the HPV DNA test covered by my patient's insurance?
Many insurance plans will cover the expense for the HPV DNA test. If you are unsure, please contact your patient's insurance provider or the laboratory.
 
Do we have to use the full 5-digit ICD-10 code?
Yes, if the code goes to 5-digits. Some codes only go to 4-digits. Using the proper ICD-10 Code makes billing claims easier for both the laboratory as well as your patient. ICD-10 Codes update annually. Please be sure to use current ICD-10 Codes.
 
My patient received a bill from the laboratory. Why did the laboratory not bill the patient’s insurance?
There are several possible answers to this question:

The laboratory billed the patient’s insurance; the balance now due is the co-pay, deductible, or balance after the patient’s insurance response to our claim.

The insurance information provided was incomplete or the patient was no longer eligible for the insurance provided.

The laboratory did not receive the patient’s insurance information and therefore, the laboratory assumed this was a cash patient.
 
Can my patient pay for laboratory services by credit card?
Yes. The laboratory will accept payment by all major credit cards and FSA Debit Cards. Please include the entire account number as well as the expiration date on a seperate piece of paper attached to the requisition.
 
We have a tissue biopsy. What size formalin container should I use?
The appropriate size container should be able to hold the specimen and enough formalin to completely cover the specimen. For small biopsies a ratio of 15 to 1 (fifteen parts formalin to one part tissue) is suggested. Formalin containers are available at no charge from the laboratory.
 
We are submitting a POC specimen. Is there anything that I have to do differently?
Yes. The Non-Gyn Tissue Requisition needs to include information as to whether the specimen is a missed abortion, spontaneous abortion, legally induced abortion and the appropriate ICD-10 coding. The POC specimen is best submitted in formalin unless the specimen is to be submitted for Chromosome Analysis. If the specimen is to be submitted for Chromosome Analysis, place the specimen in the laboratory provided screw-top tubes with sterile transport medium. Approximately 1cc of tissue which includes chorionic villi should be placed in the transport tube.
DO NOT PLACE IN FORMALIN. For further information, please contact the laboratory (818-992-7848) for a fax copy of “Protocol for Handling POC’s for Chromosome Analysis and/or Genetic Studies”.
 
How do I submit a kidney stone or bladder stone for analysis?
Place the stone in a clean, dry container. DO NOT PLACE IN FORMALIN. Complete the Non-Gyn Requisition (blue) and submit the specimen to the laboratory.
 
Why am I receiving a bill?
We are a pathology group that processes and reviews specimens, including tissue biopsies, pap test, fluids and organs removed during surgery. Your specimen(s) may have been sent to us by your Doctor or by a hospital. Your Doctor may have done a surgical procedure on you and sent your specimen to our pathology laboratory for processing and reporting, or you may have been a patient at Providence Tarzana Hospital. Not all specimens are obtained during a hospital surgical procedure. Sometimes specimens are obtained from your the doctors office.
 
My statement shows more than one charge for the same date of service, is this a duplicate charge?
Our pathology laboratory processes the specimen, and the pathologist performs an individual examination of the specimen to arrive at a pathologic diagnosis. You will see two charges, one for the technical component ( TC ), processing of the specimen, and another charge for the professional component ( 26 ), the pathologist examination of the specimen and the written narrative report he prepares. Note: these charges may share a portion of the same billing code but will show a suffix of either a TC or 26. These charges are also priced at different dollar amounts.
Charges are based on the type and number of specimens received from different surgical sites and current billing regulations dictate that each separate site be individually billed. On occasion the pathologist may need to order additional test on your specimen, for example, a special stain may be ordered to validate your diagnosis. The additional service will be charged.
 
I am a Medicare patient, why is my pap test not covered?
Medicare will only pay for one screening pap test every two years. Your Doctor may ask you to sign an Advanced Beneficiary Notice ( ABN ). This ABN notice informs the patient in writing that this screening pap test may not be paid by Medicare if this same test has been performed within the past two years.
 
I gave my insurance information to my Doctor, why are you billing me?
We may not have received your insurance information from your Doctor. If you received a statement you need to call our billing department at your earliest convenience. We will need to obtain or verify your insurance information so we may submit a bill for your services.
 
Why do I have a balance due?
Many insurance plans have deductibles and co-payments, and contractually we are obligated to bill for these amounts due. If you feel your have received a bill in error, call our billing department to discuss your statement. You may also want to call your insurance company to ensure you understand your health plan benefits.
 
I have a secondary insurance why am I receiving a bill?
Interscope will bill any secondary insurance after the primary insurance has paid. Medicare electronically forwards the charge and payment information to a number of secondary insurances on file with Medicare. Secondary insurances may make payment directly to the patient regardless if an “assignment of benefits” is on file. If you feel you have received a bill in error please call the billing department at your earliest convenience.
 
Why do I have different account numbers?
Each new occurrence will receive a new account number. We have two different types of laboratory services, pathology laboratory and clinical laboratory. Each will have separate account numbers. Should you have any questions regarding your account please call the telephone number on your bill at your earliest convenience.
 
I have a “workers compensation injury” why are you billing me?
It is possible we did not receive your workers compensation information from your Doctor or the hospital. If you are workers compensation patient you will already have a case number and a prior authorization number for this service. Please call the billing department with this information immediately so we may bill your workers insurance for these services.

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Interscope Pathology has been serving physicians and their patients in the Los Angeles area since 1975. We are committed to you and your patients, and we understand that when making a choice about what laboratory to use, accuracy, turn-around time and accessibility to a pathologist for consultation is imperative...

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