There can be various reasons why insurance did not cover your testing. Interpath Laboratory only displays in your statement the response your insurance provided us. It is always best to call your insurance first regarding how they processed your claims.
Interpath Laboratory does not code your lab order(s). We receive your lab order and all of your information including diagnosis codes from your providers office.
Lab tests being applied to your deductible are often related to the diagnosis codes we received. We cannot code your lab services and only bill out with codes provided to us. In order for us to rebill your labs we would need to receive new ones from the ordering provider. Some insurances may require chart notes when updating diagnosis codes.
An ABN Is an Advanced Beneficiary Notice:
This is a Notice that Medicare requires we provide you when a covered service is going to be denied due to various reasons as described on the ABN. You have the choice to be financially responsible for the lab testing and continue with the lab order or decline the specific test and not have it performed and not be financially responsible for that test.
A Waiver:
This is a Notice that Commercial insurances and Medicaid plans require we provide you when a covered service is going to be denied due to various reasons as described on the waiver. You have the choice to be financially responsible for the lab testing and continue with the lab order or decline the specific test and not have it performed and not be financially responsible for that test.
Did you sign an ABN/Waiver? Your insurance does not always know if you agreed to be responsible for a charge that they would normally deny. By signing an ABN or Waiver and checking “Yes” you have agreed to have services performed knowing your insurance would deny. This means that your explanation of benefits (EOB) might reflect you not being responsible, but your signed waiver is agreeing to have testing performed and be financially responsible for the specific lab test(s) cost.
We as the lab are only relaying the information we received from your insurance. If you feel that this is in error we suggest contacting your insurance plan for clarification about coverage and benefits.
To get clarification on why your Doctor has ordered lab tests on your behalf you will want to speak with the providers office for further details.
Please note that diagnosis codes are not wrong, but rather may not be supported by your specific plan for the lab testing ordered. As a laboratory we do not perform any coding. These codes are provided by your doctor’s office. For any coding questions we suggest you contact your doctor’s office for better clarification.
We offer many methods to reconcile your account balances with us
