Clients may choose to have either their patients' insurance carriers billed directly, or the client may be directly billed for laboratory services. A listing of information required to bill the respective party is specified below. If you have any questions regarding billing issues, please contact our Billing Department, Phone (703) 631-8896 Fax (703) 263-7961.
Client Billing
Clients are billed monthly for services performed the previous month. Each statement is itemized and includes the patient name, accession number, date collected, test(s) performed, CPT code(s) and charge(s). Payment terms are due on receipt.
Patient Billing
If you elect to have Clinical Pathology Laboratories bill your patient, the patient name, address, phone number and ordering physician must be clearly written on the test requisition, or identified on the order. ICD-9 Diagnosis codes must be submitted on each test requisition or laboratory order.
Third Party Billing
Clinical Pathology Laboratories will bill third party agencies or insurance companies directly for services performed. Patients will be billed only for services or charges not covered in their insurance program or contract. ICD-9 Diagnosis codes must be submitted on each test requisition or laboratory order. Clinical Pathology Laboratories is an "in-network" provider for most insurance plans. Please call our Billing department or the number on the back of the patient's insurance card to ensure your patient's testing will be covered.
The following information is necessary to properly file insurance claims:
- Date of Collection
- Patient's First and Last Name
- Patient Identification Number
- Patient Sex
- Patient Date of Birth
- Patient Address
- Patient Phone Number
- ICD-9 Diagnosis Code
- Ordering Physician
- Physician NPI Number
- Subscriber Name/Relationship
- Primary Insurance Address/Phone
- Group Number
- Advance Beneficiary Notice (ABN), as appropriate
Clinical Pathology Laboratories will accept the above information in various forms (e.g., copy of patient's insurance card, patient demographic computer sheet, etc.).
In the medical treatment of minors, parental/legal guardian consent is required including the responsibility for payment.
CPT Coding
Correct CPT coding is the responsibility of the billing party. CPT codes provided reflect Clinical Pathology Laboratories interpretation of the CPT code requirements only, as published in the current CPT Coding Manual. CPT codes may change frequently and should be periodically verified for accuracy. CLINICAL PATHOLOGY LABORATORIES ASSUMES NO RESPONSIBILITY FOR BILLING ERRORS MADE BY OUTSIDE PARTIES DUE TO RELIANCE ON THE CPT CODES LISTED HEREIN. For further information, please consult the CPT Code Manual published annually by the American Medical Association.