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General Information
Questions regarding billing should be directed to the
Cleveland Clinic Reference Laboratory
billing department between the hours of 8:00 a.m. to 4:30 p.m. Monday through
Friday Eastern Standard Time.
Local: (216) 444-0561
Toll Free: (800) 204-6741
Our Federal Tax Identification Number is: 34-0714585
Billing Options
Several billing options are available, including:
- Client (hospitals, referring laboratories, group practices,
physicians, industrial accounts, and other healthcare providers)
- Medicare/Medicaid
- Commercial third party insurers
- Patient
Client Billing:
- Clients receive itemized invoices on a monthly basis. They are generated at the close of the last day of each month.
- Invoices will indicate date of service, patient name, referring physician, test(s) performed, CPT code, accession number, test 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, State of Ohio Medicaid plans, or other third party commercial insurers be billed directly.
- All information must be provided as outlined on the
Test Request Form (PDF).
- An appropriate ICD-9 diagnosis code is required for each test ordered.
- To avoid incomplete or misinformation, we recommend that a copy (front and back) of the patient's insurance card be attached to the
Test Request Form (PDF).
If the required information is incomplete the client will be required to assume responsibility and will be billed for all charges.
- Claims filed to the patient's third party carrier (except Medicare and 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
Ohio Medicaid billing.
- The laboratory does not bill Medicaid for states
other than Ohio.
Patient Billing:
- Clients may request that a patient be billed directly.
- All information must be provided as outlined on the Test Request Form
(PDF).
If the required information is incomplete the client will be
required to assume responsibility and will be billed for all charges.
- Please advise your patients that they will receive a bill for laboratory services from
the Cleveland Clinic Reference Laboratory; that they are solely responsible for these
charges; and that payment is due upon receipt of their bill.
CPT Coding
CPT Codes are provided (in the Test
Directory) as a convenience to our clients as guidance to assist you in billing. Since 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
- Cleveland Clinic Reference Laboratory reserves the right to review credit reports from reporting agencies such as
Dun & Bradstreet, TRW, etc.
- 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.
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 ABN form
(PDF)
is completed and signed by the patient. Under these circumstances, an ABN form must be submitted with the specimen. To acquire ABN forms
(PDF), instruction
(PDF)
as to their use, or if you have related questions please contact the
Cleveland Clinic Reference Laboratory
Billing
Department.
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General
Information
Billing Options:
CPT
Coding
Credit
& Collection
Advance
Beneficiary Notification (ABN) Form
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