Why
did I receive an AmeriPath bill?
Your physician has
chosen AmeriPath Anatomic Pathology or Dermpath Diagnostics,
divisions of AmeriPath, to diagnose and interpret the specimen removed
at
the time of your recent office visit.
Widely recognized as the premier anatomic pathology/ dermatopathology
laboratory network in the United States, our outstanding record
of achievement and success is the basis on which we guarantee that you
will receive the
most timely and accurate diagnosis possible.
As with any medical service, questions or issues concerning coverage
or medical billing may arise. If they do, please call the AmeriPath
Customer Service Department at (toll free) 800.354.3449. Rest
assured that this
department will resolve all relevant questions or issues in an
efficient and timely manner.
The billing for healthcare services can be complex; therefore, AmeriPath
has prepared this pamphlet to help you understand its billing procedures.
Who is AmeriPath, and what is its function?
AmeriPath is a nationwide network of anatomic pathology
laboratories. It is the nation¹s leading provider of cancer diagnostics,
genomic and related information. AmeriPath employs over 425 board-certified
anatomic pathologists with multiple subspecialties. Furthermore,
its
specialists
are linked through numerous modes of communication and
are able to pool their expertise and respond quickly when consulting
on
unique or difficult
cases.
Do AmeriPath's
pathologists treat patients directly?
AmeriPath's pathologists
do not treat patients directly. Rather, they assist your physician
by establishing
a definitive diagnosis and providing consultations regarding
effective treatment plans.
How is AmeriPath related to those divisions known as Anatomic Pathology
and Dermpath Diagnostics?
They are important
subdivisions of AmeriPath. Dermpath Diagnostics, for instance,
is AmeriPath's foremost entity in the diagnosis,
treatment and management of skin disease.
AmeriPath centrally manages all matters of insurance, medical
billing and customer service for these
divisions.
What is the function of these anatomic pathology laboratories?
Their board-certified pathologists diagnose the existence
of disease and provide invaluable assistance to your physician concerning
the diagnosis, treatment and management of disease.
What are anatomic pathology tests?
They are tests
that involve the application of established scientific laboratory procedures
for the evaluation of organs and tissues.
The interpretation
of test results usually requires the services of a board-certified
pathologist, such as a dermatopathologist who
specializes in the diagnosis, treatment and management
of skin disease.
How are my tissues evaluated by my doctor?
Having sent your tissue sample (biopsy) or cell sample (body
fluid or PAP smear) to his or her supporting AmeriPath anatomic
pathology laboratory for evaluation and interpretation, your physician
is now in
possession of the definitive information needed for the proper
diagnosis and treatment of disease.
Who is responsible for paying for anatomical testing?
Ultimately, the patient is responsible for the payment of
fees related to pathology testing. These fees are independent of those
charged
by your physician for visitations to his or her office.
Who bills my commercial insurance company for pathology services rendered?
When provided with all of the information it requires, AmeriPath
will, on your behalf, submit billing claims to your commercial
insurance carrier. Patients are responsible for the payment of unpaid
balances.
What about claims to Medicare?
AmeriPath diagnostic services are covered under Medicare Part
B, and AmeriPath will, on your behalf, submit your Medicare
claim. AmeriPath accepts assignment on all pathology testing, meaning
that it will accept
the dollar amount (as the amount you will be charged) that
Medicare allows for these services. Since Medicare pays only 80% of
the allowed amount
for this type of testing, you will be billed for the remaining
20%, along with any deductible. Should you have a secondary insurance
carrier, AmeriPath
will, on your behalf, submit your claim for the remaining 20%
to that carrier. Again, patients are responsible for the payment of
unpaid balances.
What about other insurance plans?
Should your
insurance company contract directly with AmeriPath for anatomic pathology
services, AmeriPath
will file a billing claim, on your behalf, to your insurance
company for any pathology testing requested by your physician. All
remaining balances will
then be submitted to you for final payment. If not contracted
with AmeriPath, however, your insurance company may pay only
a portion (or none) of your
claim. Prior to the actual conduct of anatomic pathology
services, you are urged to check with your insurance carrier
for verification of
coverage
in that you are
ultimately responsible for any unpaid balance.
Why didn't
my insurance company cover the entire amount?
Some insurance plans
do not cover all of the pathology services rendered. When this occurs,
AmeriPath bills the patient
for the remaining co-payment, deductible or balance due. If you
believe that
your insurance
company erred in processing your claim, please call the
AmeriPath Customer Service Department whose representatives will
work with you
to assess
coverage issues and assist you in interpreting your insurance
carrier¹s
payment determination.
Which tests are considered anatomical?
The following are examples of anatomical laboratory tests that
could appear on your statement:
- Surgical Pathology
- Cytopath Smear Review
- Fine-Needle Interpretation
- Special Stains
- Histopathology Examination
- Immunocytochemistry
- Immunofluorescence
How will AmeriPath inform me of the status of my account?
Should its laboratory perform anatomical tests, AmeriPath will
send you a billing statement after Medicare responds to your
claim. A typical statement will include the following:
- List of charges
- Test description/CPT code
- Date of service
- Name of referring physician
- Name of pathologist
- Insurance information
- Medicare payment or response
- Remaining balance
Why could I receive two bills after a single visit to my doctor?
You may receive one bill from your doctor for services performed
at his or her office, e.g., the collection and preprocessing
of a specimen. You may receive a second bill from AmeriPath for
its completion of laboratory,
interpretative and diagnostic tasks (requested by your doctor)
pursuant to your specimen. Please remember that both your doctor
and his or her
supporting pathology specialists have separate fee structures
and billing procedures. Should questions persist, please contact
the AmeriPath Corporate
Billing Office.
