Billing

Pathology Associates Patient Accounts 563-556-2012

Frequently Asked Questions

What method of payment is accepted?

Credit/debit card, Discover, Mastercard, Visa, money order or check. (There will be a $25.00 processing fee for all checks returned for insufficient funds.)

I've received a bill from a collection agency. Who can I pay?

Once your account has reached 90 days past due then it is sent to a collection agency. This account then becomes the responsibility of the collection agency to collect; you can pay directly to the collection agency or to Pathology Associates. The Collection Agency is Tri-State Adjustments and can be reached at 800-550-2988.

I have already paid my co-pay at the referring physician's office and I am getting charged for this again from Pathology Associates for the same date of service, why am I paying this twice?

Pathology Associate's claim was probably received at your insurance company before the referring physician claim. The insurance company applies deductibles, co-pays, etc. to claims as they are received and processed. Please contact your insurance plan to see if this is what happened, and if so please contact the referring physician's office to see if they show a refund due to you for overpayment on your account.

My insurance applied these charges to my deductible. My deductible has been met, why did my insurance company process the claim this way?

You may have two separate deductibles; one for in-network claims processing and another for out-of network claims processing. Please contact your insurance plan at the telephone number provided on the back of your insurance card to inquire about why they processed your claim in this manner.

My insurance company will not pay for a certain portion of charges that they call UCR (Usual, Customary and Reasonable). Am I responsible for the UCR amount due on my account?

The UCR is the amount your insurance carrier considers the Usual and Customary allowance for this procedure. UCR adjustments are not allowed unless we have a signed contract with the insurance carrier. Some policies have RAPS provisions. This is an acronym for Radiology, Anesthesia, Pathology and Surgical procedures. These are also referred to as ARPS (Anesthesia, Radiology, Pathology and Surgical). You may want to check with your insurance carrier to see whether your policy has a RAPS provision.

Many times there are RAPS for facility only; which means that if you were seen at a hospital or Skilled Nursing Facility setting; such as a care center, RAPS may apply and your claim could be covered at in-network levels. Other plans have RAPS if you were seen by an in-network referring physician. If you were seen by a participating provider then anything submitted to Radiology, Pathology, Anesthesia and Surgery for further testing is covered at in-network levels if you have this RAPS provision on your policy. It is your responsibility to check with your insurance plan and verify that any referrals and prior authorizations are in place before services are provided.

I would like a second opinion and I am scheduled to see a physician at another facility. Can you send my pathology slides and/or blocks with pathology reports to the outside facility?

Yes, we can send this material to the outside facility. We will need a faxed order from your referring physician as well as a signed consent from you authorizing us to release this material/information to the outside facility (Authorization to Release Health Information Form). We will also need the mailing information of the facility you want us to send this material to; appointment date, the physician name, dept, mailing address, telephone number, fax number and what material is to be sent. Please call 563-589-9827 when this material is completed or for additional questions.

I've already received a bill from UCL for my pap smear and I am now receiving charges from Pathology Associates. Why am I receiving a bill from both facilities?

United Clinical Laboratories (UCL) bills for a pap smear that is reviewed by trained cytotechnologists. In certain cases (depending on what your pap smear shows and the cytotechnologist's findings), a Pathologist may also need to review your pap. If the pap smear is interpreted by the Pathologists, then the pap interpretation charge is billed by Pathology Associates. These cases will have two separate charges.

Why am I getting a bill from Pathology Associates for a specimen that I dropped off at United Clinical Laboratories?

Pathology Associates is a group of board certified Pathologists whose job is to interpret particular kinds of specimens (e.g. urine, fluids, biopsies, etc.). They are the Medical Directors of United Clinical Laboratories overseeing all laboratory functions. They will be directly involved in interpreting certain specimens and will bill directly for these procedures.

Who can I contact with additional questions regarding my bill?

Our billing office at 563-556-2012