No, while Medicare rules allow payments for most procedures, a few categories are not covered and will result in a bill to the patient. Categories not covered by Medicare include:

• Screening procedures: Procedures that might be ordered as part of a routine exam (for example, yearly physical) are in most cases not covered.
• Items not medically necessary: For some procedures, Medicare maintains a list of diagnoses (reasons for testing) for which they will pay for the particular test. If your particular diagnosis is not on this list, Medicare will not pay.
• Investigational tests: Tests that are not yet approved by the FDA are considered experimental or investigational and are never covered by Medicare.

When our laboratory believes that Medicare will not cover a test, you will be asked to sign and date an “Advance Beneficiary Notice.” We will submit the bill to Medicare and then bill you for services they deny.

Please allow your insurance company 4 to 6 weeks to process your claim. If your insurance claim has not been processed in that amount of time, contact your insurance company directly for further information.

Interpath Laboratory will send a claim to your insurance company but you may be responsible for the full dollar amount billed.

You should have received an Explanation of Benefits (EOB) from your insurance carrier that explains in detail the services that were either paid or denied. If you need further assistance determining the reason(s) why your insurance company did not pay for the performed services, please contact your insurance carrier directly.

If you have more than one insurance policy, you must submit to the secondary insurance company directly with a copy of your Explanation of Benefits (EOB)from your primary insurance company. Mail the bill you received, along with the EOB, to your secondary insurance company’s claim processing address.

Please read your bill carefully. A line item adjustment will be printed on your bill if we have received payment from the insurance company. If you are still uncertain, you can either contact your insurance company directly or contact the Patient Billing department at (866) 289-4093.

Yes, we will bill your secondary insurance organization, but we need this information:

• Insurance organization’s name and address
• Your policy and group numbers
• Policyholder’s name and employer

We will file your secondary insurance once as a courtesy.

Yes, we will bill your primary insurance organization, but we need this information:

• Insurance organization’s name and address
• Your policy and group numbers
• Policyholder’s name and employer

We will file once as a courtesy. If the insurance does not respond in a reasonable amount of time, a tracer letter will be sent to your insurance company. This bill remains your responsibility. Contact the insurance company and see if any additional information may be needed from you.

The hospital bills you for the use of their facility and the supplies used during your stay. The physician or specialist bills you for services that he or she performed.

We don’t show treatment and diagnosis information because we handle the billing portion of the medical process. If you have questions about your treatment, diagnosis or other medically-related questions, contact your health care provider.

Yes, call us at (866) 289-4093. Ask if you can set up a payment plan to pay a minimum of $20.00 each month. Then make the agreed payments. If you don’t pay and don’t make arrangements, your account may be turned over to a collection agency.

Payment can be made over the phone or by mail by using VISA, MasterCard, Discover or by personal check. There is no additional fee for using the pay by phone service, please call (866) 289-4093. Also, Interpath has a new feature called Online Bill Pay. It will allow you to register via a secure login process and pay your invoice online.

Yes, we normally can bill Worker’s Compensation, but we need the following information:

• Social security number
• Name of your employer
• Date of injury
• Worker’s Compensation claim number
• Name and address of the Worker’s Compensation carrier. (The carrier is usually your employer – in some states, it’s the Worker’s Compensation Commission.)

The bill you have received in the mail represents charges for laboratory services performed by Interpath Laboratory that were not covered by your insurance. Laboratory services are not part of your physician bill and are billed to you directly from Interpath Laboratory.
Additional reasons for receiving a bill:

• No response from insurance company: Sometimes we don’t know the reason why an insurance company does not pay. We know they have not responded with a payment or a denial within the time specified (usually 60 days). When this happens, it is your responsibility to resolve this matter with your insurance company.
• Unable to identify patient due to incorrect name or ID number: If your insurance company knows you as “Robert,” do not use “Bob.” Insurance companies are unable to identify you when the name and ID number on the claim are not an exact match with the name and ID number listed on the insurance card.
• Coinsurance, co-payment or deductible: This is the amount due from you as determined by your insurance plan. Please review your policy. Deductibles must be paid before the insurance company will begin to make payments.
• Diagnosis is missing: In addition to needing to know what service you received, insurance companies want to know why you received the service. Your physician must supply a diagnosis code that supports the reason why the test was ordered.

The Advanced Beneficiary Notice (ABN) is a form that we ask Medicare patients to sign if we think that the diagnosis code that we have may not justify medical necessity, or that the test may exceed frequency guidelines set by Medicare. This is our way of informing the patient that they may be responsible for payment if Medicare does not pay.

We have Patient Service Centers located across Oregon, Washington, and Idaho for your convenience. Please see the link above for Contact Us where you will find our locations.

Yes, Interpath has a new feature called Online Bill Pay. It will allow you to register via a secure log-in process and pay your invoice online.

If you have questions about your bill or you would like to pay a bill by phone please call our billing office at (866) 289-4093.

PLEASE HAVE THE FOLLOWING INFORMATION READY:
Insurance Card, Explanation of Benefits, or Bill

The billing office is open from 7:00 a.m. to 5:00 p.m. Monday through Friday, PST.