Wiki Global billing for pathology service

[dobsonphillips]

If you have 1 tax id number, but you are peformed technical component in one state and sending the slides to another state to be read by a pathologist employed by the same lab, should this be billed globally or spilt? If globally which state should billed- the one performing the reading or the one preparing the slides.

 

[Kris Cummings]

Is this for a pathology specimen submitted by a separate entity other than the company you are billing the service for?

 

[dobsonphillips]

Urology is sending the specimens to us.

 

[Kris Cummings]

What I'm reading is that a urologist office takes a specimen and submits it to your laboratory.

Your laboratory then prepares the slides and then sends them to another laboratory, still same company, in another state for the physician to review, interpret and create a report? Both of these laboratories are

Am I understanding correctly?

 

[dobsonphillips]

Yes, you are correct same tax id, but different NPI numbers.

 

[Kris Cummings]

Okay, well, after giving this some consideration I would recommend contacting your primary carriers in the state the test is performed in. They may have specific guidance on any state law(s) that may pertain.

Considering that both services are done by the same company, same tax ID number (I presume same specialty of pathology?), it would seem that this would fall into a "contractual" issue where the "billing provider" receives the entire global payment and has a contract with another provider to perform a portion of the service for payment.

Having said that, it also would seem within the company there would be some type of policy on splitting payment for professional and technical components between the two providers. With that in mind, perhaps also check with your company financial officer.

I know this probably isn't a ton of help, but hopefully some.

Let me know what you find out, perhaps it will help me in the future.

Kris