Monday, November 30, 2009

Being (possibly) billed for lab tests at Marshall

When you go to lab to get blood tests done and you are asked to sign a paper you are NOT being told that you WILL be billed.

Marshall recently bought new billing computer software that automatically prints out a form called an Advance Beneficiary Notice (ABN) whenever a doctor orders a test that has a limit on how often it might be done or has often been not reimbursed to Marshall.

This form tells you that:
  1. Your doctor feels you need this test.
  2. If your insurance, for some reason, refuses to pay Marshall for doing the test, Marshall may bill you for it.
Problem is, Marshall's billing people are not involved in tell you about this or helping to determine whether or not you actually will get a bill or not. The lab people are just being asked to have you sign the paper whenever the computer prints one out.

You won't get a bill for:
  1. annual screening tests done at least a year after the last one
  2. diabetic glycohemoglobin tests (HbA1c) at any frequency at all for out of control diabetes
  3. tests often ordered for screening but ordered for non-screening purposes, such as a mammogram for an abnormal screening mammogram, or a PSA test for an enlarged prostate.

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