Can anyone please help me with this lab related question. I have a private insurance pt who had recieved an order for labwork from another doctor/specialist, and the pt went ahead and got it done from a lab. Now, does anybody know if the insurance is going to deny payment to the lab and we will be responsible to pay for this. And what is the best way to handle a situation when such an order is given by a physician who hasn't signed the POC.
Thank you very much in advance.
Apr 18, '09
Wouldn't that be a matter between the patient and their insurance carrier? Where was the agency in all of this? I don't think the agency pays for anything the patient does on their own. The agency nurse did not accompany the patient to the lab did they, so how can the agency be involved?
Apr 19, '09
Not quite sure exactly what you are getting at. Any lab costs/billing are billed to patient's insurance whether the agency or the lab draws them...you need to be sure that the appropriate codes are on the lab slip in order for it to be paid for as well. If the patient tells me that they need lab work done - I will draw the labs after I verify it with the doctor who ordered it...does not matter if it is the MD who signs the 485 or not. As long as you have a MD to sign your orders...or if the lab slip is signed by the MD in black and white- you are covered. We do not usually make a visit specifically for labs since that is not a skill covered by Medicare/insurance. Hope that helps