Required Billing and Insurance Information

When possible, Geisinger Proven Diagnostics will directly bill a patient or his insurance company. We would prefer to have a copy of both the front and back of the patient's insurance cards, along with complete patient demographic information. If a card is not available, the grid below illustrates what information is needed for correct billing. Along with that information, a medically necessary diagnosis for each test ordered must be provided on the test requisition. Providing this information up front will keep your patients from getting unnecessary bills and eliminate phone calls to your office.

 
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