Question Pricing lab components for panels

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Our office now uses lab corp for some panels but we pay lab corp a fee rather than them billing patients. The fee for this needs to be added to the pricing on our end. My question is do I enter the fee on each component for the panel? In the example below that would be a HUGE bill, any guidance would be great.

example: P5023 Inheritest Carrier Screen, Society-guided Panel (14 Genes) (LC)
Components 81200, 81209, 81220, 81242, 81243, 81251, 81255, 81257, 81260, 81329, 81330, 81361.
Lab corp fee to us is $693.00
 

karamac

Networker
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34
Location
Glendale, Arizona
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This is a complicated question- because first you are pass thru billing which may not be permitted by your carriers, especially medicare. Second, most states even when allowed may not allow you to mark up the price of the test. You would need to amend the 90-modiifer to all of the codes not performed, and does your CLIA permit you to perform this level of testing? This is genetic testing for inherited conditions - and would not recommend that you try and pass thru bill this service as each payer will have very specific guidelines on when and how it is covered. And it is going to be expensive.

I guess the bigger question I have is, why, since LabCorp is in Network are you just not having them bill the insurance directly, handle the prior authorization?
 
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