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Renal Pathology Consultation Service
Amani Bashir, MBBS and Danni Holanda, MD
                                            
A national anatomic and clinical pathology reference laboratory
affiliated with UI Health Care

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Department of Pathology

 Billing Policies


GENERAL INFORMATION:

Questions regarding billing should be directed to the billing department between the hours of 8:00 a.m. to 4:30 p.m. Monday through Friday, Central Standard Time.

Local: 319-356-2991            Toll Free: 866-844-2522

Our Federal Tax Identification Number is: 42:6004813

BILLING OPTIONS:

Several billing options are available, including:

  • Client (hospitals, referring laboratories, group practices, physicians, industrial accounts, and other healthcare providers)
  • Medicare/ Iowa and Illinois Medicaid
  • Commercial third party insurers


Client Billing:

  • Clients receive itemized invoices on a monthly basis. They are generated at the close of the first day of each month.
  • Invoices will indicate date of service, patient name, test(s) performed, CPT code, and the test price.
  • Invoices are considered to be correct unless notified within 30 days of the invoice date. Notification of transfers/rebillings must be made to the billing office within this time frame in order to ensure timely billing. Requests received after 30 days will not be processed.
  • Payment terms are net 30 days.
  • Purchase order numbers are displayed on the invoice if provided.


Third Party Billing:

  • Clients may request that outpatient Medicare, Iowa and Illinois Medicaid, or other third party commercial insurers be billed directly.
  • All following information is required for all specimens submitted to a patient’s insurance. Requisitions submitted with incomplete or inaccurate billing information will be billed to the referring institution as a client bill.
     1. Patient Name
     2. Patient Address
     3. Patient date of birth and gender
     4. Primary insurance name and mailing address
     5. Primary insurance ID number
     6. Subscriber's name (policy holder)
     7. Subscriber's relationship to patient
     8. Supplement/secondary insurance name and mailing address
          (if applicable)
     9. Supplement/secondary insurance ID number
    10. Subscriber of secondary
    11. Referring physician (first and last name)
    12. Referring physician's UPIN number
    13. Diagnosis code(s) (required for clinical lab testing)
  • To avoid incomplete or misinformation, we require that a copy (front and back) of the patient’s insurance card be attached to the Test Request Form. If the required information is incomplete the client will be required to assume responsibility and will be billed for all charges.
  • An appropriate ICD-9 diagnosis code is required for each test ordered. If the ICD-9 code is not provided, referring entity will be billed.
  • Claims filed to the patient’s third party carrier (except Medicare, Iowa and Illinois Medicaid) which go unpaid for 60 days will be billed back to the patient.
  • Patients are responsible for the yearly deductibles, co-payments, and any balance not covered by their insurance company. Assignment is accepted on Medicare and Iowa Medicaid billing.
  • Please advise your patients that they will receive a bill for laboratory services from the Department of Pathology Outreach Service; that they are solely responsible for these remaining charges; and that payment is due upon receipt of their bill.
  • The laboratory does not bill Medicaid for states other than Iowa and Illinois.


ADVANCE BENEFICIARY NOTIFICATION (ABN) FORM:
The ordering physician is responsible for ensuring that lab procedures requested are medically necessary by federal guidelines in order to bill Medicare. The Medicare program will allow the laboratory to bill the patient for non-covered services only if an Advance Beneficiary Notification (ABN) form is completed and signed by the patient. Under these circumstances, an ABN form must be submitted with the specimen. To acquire ABN forms, instruction as to their use, or if you have related questions please contact the billing department.


CURRENT PROCEDURAL TERMINOLOGY CODING (CPT):
CPT Codes are provided in the University of Iowa Diagnostic Laboratories Test Directory as a convenience to our clients. CPT codes are subject to change at any time, it is the client’s responsibility to verify their accuracy for the test performed. Clients are encouraged to consult the CPT Coding Manual published by the American Medical Association and to address questions regarding the use of any particular code to their local Medicare carrier.


CREDIT AND COLLECTION:

  • The Department of Pathology Outreach Services reserves the right to review credit reports from reporting agencies.
  • All invoices are due in full upon receipt and must be paid within 30 days from the date billed.
  • All claims, requests for adjustments, or notification of errors must be made within 30 days of the invoice date or charges are considered to be accepted.
  • Charges unpaid after 90 days are subject to collection. The purchaser will assume all collection expenses, attorney fees, and court costs.