If you feel there is an error with the bill that you have received,
please call Lori Tedesco-Williams at Geisinger Proven Diagnostics. Her phone number is 570-214-5614, or call our Client Services
Department at 1-866-869-1334 and ask to speak to Lori. (top)
Certain laboratory services have a technical and professional component.
The technical component accounts for the processing and testing materials
used, while the professional component is the pathologist's interpretation
of the
results. (top)
If you receive a call from one of the Geisinger Proven Diagnostics insurance apecialists it is
because we are missing valuable information to process your claim accurately. (top)
Yes. If your office prefers that Geisinger Proven Diagnostics bill you
directly, please contact your customer care rep. Geisinger Proven Diagnostics has the ability to
bill laboratory services to your
facility
directly or bill your patients' insurance. (top)
If you do not provide a diagnosis code, or if you provide a code that
is not considered medically necessary by Medicare guidelines, Geisinger Proven Diagnostics will contact
your office and attempt to obtain a valid diagnosis. A diagnosis code must
be provided for every specimen submitted to Geisinger Proven Diagnostics for testing. (top)
If you choose to have your office billed directly
by Geisinger Proven Diagnostics, rather than having Geisinger Proven Diagnostics bill your patients, you will
receive an itemized statement, including
date
of service, patient name, test performed, CPT code and test price.
This statement will be sent out monthly. (top)
A copy of the front AND back of the patient’s
insurance card is the best way to ensure that your patient's insurance will
be billed correctly
on
the first submission. (top)
If your patients receive a bill and do not understand why,
it may be due to copays, deductibles or balances not covered by their insurance.
Patients
will
be responsible for copays, deductibles or balances not covered by their
insurance. (top)
When selecting an appropriate diagnosis code for a patient's lab work,
be sure to check to see if the ICD-9 code needs a 4th or 5th digit specificity.
These end digits provide a greater specificity of the health condition
and are necessary for payment. (top)
789.0 Abdominal Pain requires a 5th digit which specifies that area
of pain.
789.00 Unspecified
789.06 Epigastric
789.07 Generalized 780.7 Malaise and fatigue requires a 5th digit
780.71 Chronic fatique syndrome
780.72 Functional quadriplegia
780.79 Other malaise and fatigue (top)
585 Chronic Kidney disease requires a
4th digit.
585.1 Chronic Kidney disease, stage 1
585.2 Stage II (mild)
585.3 Stage III (Moderate)
585.4 Stage IV (Severe)
585.5 Stage V
585.6 End stage renal disease
585.9 Chronic kidney disease, unspecified (top)
Geisinger Proven Diagnostics creates a new encounter
each time a specimen is received on a patient. We need a copy of the
front
and
back
of the
insurance card each time a
specimen is sent to ensure accurate billing. We need insurance information
with every
specimen, because each invoice is treated as a new bill. We do not
keep a file on individual patients. (top)
Geisinger Proven Diagnostics will accept all insurance plans.
This is just a list of common plans that we accept. (top)
When a patient is eligible for Medicare, they
have the option to have a Medicare Advantage Plan. When this option is
selected, the Advantage Plan
is
now the patient's primary insurance coverage and replaces the patient's
traditional Medicare A & B. The patient should no longer have a traditional Medicare
A & B Card. (top)
When a patient is eligible for Medicare they have the option to have
supplemental insurance for gap coverage. When a patient had Medicare as well
as any supplemental
products, Medicare is primary and the supplement is always secondary coverage. (top)
Medicare will pay for a screening PSA as a preventative
service (for details see the frequency
guidelines link). When the screen
is being done
for this
purpose you should order Geisinger Proven Diagnostics code PSAS. If a PSA is being done for
diagnostic reasons you should order Geisinger Proven Diagnostics code PSA. (top)
