Doesn’t Medicare pay for all laboratory testing?
No. Medicare Part B covers medically necessary clinical diagnostic laboratory services when your doctor or practitioner orders them. Laboratory tests include certain blood tests, urinalysis, tests on tissue specimens, and some screening tests. If you have questions about whether a test is covered, please contact us.
What happens if Medicare does not cover a service ordered by my doctors?
When our laboratory believes that Medicare will not cover a test, you will be asked to sign and date an “Advance Beneficiary Notice of Noncoverage.” We will submit the bill to Medicare and then bill you for services they deny.
What is an ABN or an Advanced Beneficiary Notice?
The Advance Beneficiary Notice (ABN) is a form that we ask Medicare patients to sign if we think that your test may not be covered by Medicare. The ABN lists the items or services that Medicare isn’t expected to pay for, along with an estimate of the costs. This is our way of informing the patient that they may be responsible for payment if Medicare does not pay.
How long will it take before my insurance company responds to this claim?
Please allow your insurance company 4 to 6 weeks to process your claim. If your insurance claim has not been processed in that amount of time, contact your insurance company directly for further information.
Why didn’t my insurance pay this claim?
You should have received an Explanation of Benefits (EOB) from your insurance carrier that explains in detail the services that were either paid or denied. If you need further assistance determining the reason(s) why your insurance company did not pay for the performed services, please contact your insurance carrier directly.
How can I find out if my insurance company has paid this claim?
Please read your bill carefully. A line item adjustment will be printed on your bill if we have received payment from the insurance company. If you are still uncertain, you can either contact your insurance company directly or contact the NWL Billing department at 360.734.8802 or e-mail firstname.lastname@example.org
Will you bill my secondary insurance?
Yes, we will bill your secondary insurance organization. Please provide the following:
- Insurance organization’s name and address
- Your policy and group numbers
- Policyholder’s name and employer
Why am I being charged a draw fee?
A draw fee is charged when a patient goes to one of our Patient Service Centers (PSC) for the drawing of a specimen. Insurance may cover this fee for many of our patients. However, patients whose insurance does not cover the draw fee and uninsured patients are responsible for payment of the draw fee.
Why am I being charged for additional testing which was not on my original test order (requisition)?
There are two reasons that an additional test, which was not originally ordered by your physician, would be performed. The first is that your physician may have called the laboratory to request additional testing after the order was submitted. The second is that one of the tests your physician ordered may have been a “reflex” test. Reflex testing may result in an additional test being performed depending on the results of the original test. The reflex test is performed to get more detailed information about the findings of the initial test.