All tests which are both ordered and performed will be billed to the appropriate payer under the guidelines provided by the payer and in accordance with all Federal, State and local laws and regulations. Patient Billing:
Providence Laboratory provides patient billing as a service to our clients. We can bill the patient’s insurance carrier, Medicare or Medicaid directly. If you are sending a specimen collected at your office or facility, please include the necessary patient financial information. Third Party Billing:
For third party billing, please include the following information:
- Name of insured and date of birth
- Name of their employer
- Copy of their insurance card (front and back)
or a copy of the patient’s face sheet
or the following information:
- Name of insurance carrier
- Address of carrier
- Insured Social Security Number (subscriber number)
- Group number
Pediatric Patients:
For pediatric patient billing, please include the following information:
- Name of the patient’s parent or guardian
- Billing information for the parent or guardian Client Billing:
Please contact Providence Laboratory Client Services at 261-3631 if you would like to set up a client account. To charge to an active client account, mark the appropriate space on the laboratory requisition form and provide your client account number. Medicaid:
For Medicaid patients, please include a copy of the current month’s sticker. Medicare:
For Medicare beneficiaries, the following information is necessary:
- Copy of the patient’s Medicare card
- Completed and signed Medicare Second Payer questionnaire (on the back of the outpatient requisition)
- Completed and signed Advanced Beneficiary Notice if any of the designated tests have been ordered
Medicare patients must provide Medicare Second Payer (MSP) information. An MSP questionnaire is included on the back of the outpatient requisition form. Patients who will be drawn at Providence Outpatient Laboratory or the Main Laboratory can provide the MSP information at the time of registration. If you are sending a specimen collected at your office or facility, please have the patient complete and sign this questionnaire. An Advanced Beneficiary Notice is required if tests that are likely to be denied payment by Medicare are ordered. Tests that are subject to limited payment are listed in red on the requisition form for physician convenience. Medicare will not pay for the following tests:
- Screening tests or in conjunction with a routine physical exam (exception is yearly PSA and screening PAP smear available every two years)
- Tests that lack FDA approval or are considered experimental/investigational
- Some tests based on diagnosis provided or order frequency
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