Required Billing Information

A medically necessary diagnosis for each test ordered must be provided. Providing this information up front will keep your clients from getting unnecessary bills and eliminate phone calls to your office.

Please refer to the table below for required patient information:

 
Geisinger Health Plan
Blue Cross/ Blue Shield
Medicare
Medicare Replacement
Medicaid
Commercial
Patient Self-Pay
Full Name
X
X
X
X
X
X
X
Sex
X
X
X
X
X
X
X
Date of Birth
X
X
X
X
X
X
X
Address
X
X
X
X
X
X
X
Phone Number
X
X
X
X
X
X
X
Relationship to Subscriber or Guarantor
X
X
X
X
X
X
X
Medicare Number
  
  
X
  
  
 
 
Medicaid Number
 
 
  
 
X 
 
  
Contract/ Policy Number
X
X
 
X
 
X
 
Group Number
X
X
 
 
 
 
 
Plan Code
 
X
 
 
 
 
 
Insurance Company Name
 
 
 
X
 
X
 
Insurance Company Address
 
 
 
X
 
X
 
ICD-9 Diagnosis Code
X
X
X
X
X
X
 

HMO Plans:

In addition to the information required for other insurance billing, HMO policies require a pre-authorization unless Geisinger Proven Diagnostics is contracted with the HMO.  Preauthorization for HMOs must be obtained by the patient's primary care provider (PCP).