Rand Medical Billing Frequently Asked Questions (FAQs)
My statement shows more than one charge for the same code number
on the same date of service. Is this a duplicate charge?
The method of charging pathology
services is established by the American Medical Association and
is used by all pathologists. Pathology
charges are based on the number of specimens examined and the number
of procedures performed on each specimen. For example, two biopsies
taken from separate sites in the colon during colonoscopy would
each
be charged
separately. In this case, your statement would show two identical
charge codes on the same date of service. These are not duplicate
charges.
Insurance paid for my pathology and I paid as well. How do I get
a refund?
Refunds typically take 60 days to process. A list of any refunds
due is sent by Rand to the pathologist toward the end of the month.
The pathologist issues a check to Rand for all of the refunds due,
and Rand issues a check to the patient toward the end of the following
month. Refunds are always paid out even if they have not been requested
by the patient.
I sent you my insurance information. Why am I still receiving statements?
The patient is ultimately
responsible for paying for professional and technical pathology
services if insurance doesn’t pay all
or some of the charges and they are not otherwise adjusted off
of the bill. We believe that is important that you be
kept
fully informed about your account status even while charges are
being considered by insurance. You will continue to receive
statements
for your pathology services until the account is brought to a zero
balance.
I gave the hospital my insurance information. Why do I need to
give it to you again?
Rand receives electronic transmittal
of patient information from the hospital. Most of the time the
information is complete and accurate,
but not infrequently, the data was not entered correctly into the
hospital system or the data we received was not complete. Sometimes
we never even receive the data from the hospital. We recognize
that it is a nuisance for you to have to re-submit your insurance
information,
but
we do not have control the information that was sent to
us.
I gave my billing information to the doctor’s office. Will
you bill my insurance?
Whenever we receive insurance
billing information, we bill the third party payer and send a statement
to you. The statement
asks you to make sure that the billing information is correct and
it describes the charges. Even though insurance has been billed, you
will continue to receive statements until the account is brought
to a zero balance.
I have primary and secondary insurance will you bill my secondary?
As long as we have billing information for the secondary payer,
we will automatically bill the secondary after the primary pays.
I never saw this doctor. Why are you billing me?
Rand bills for the services that pathologists
provide to patients who receive medical care in hospitals, doctors’ offices and
dentists’ offices. These services include the examination
of tissue biopsies, aspirated fluid, blood specimens, urine specimens,
stool specimens and other types of laboratory specimens. At the
time
that your specimen was taken, you may not have realized that it
was sent to a pathologist who is a specialist in anatomic pathology
and
laboratory medicine. You are receiving a bill for the examination
of one or more specimens that were sent to the pathologist or to
the laboratory.
I gave you my insurance information last time I had a biopsy. Why
do I have to give it to you again?
Because most patients use
pathology services once or only infrequently, the Rand computer
system assigns and tracks one account number for
each separate specimen or set of specimens. The system does not
recognize patients from previous encounters and the volume of work
we receive
does
not
permit us manually check billing information sent with previous
biopsies.
Why do I have two account numbers?
We assign a separate account number to each specimen or set of
specimens examined by the pathologist, and separate account numbers
for tissue specimens and laboratory specimens. These account numbers
are usually not linked, so you may be asked to provide insurance
billing information for each account number or to let us know that
the insurance is the same on both accounts.
This is a Workers' Compensation case. Why are you billing me?
We were not advised that the pathology services provided were a
result of a work-related injury. In order to bill Workers' Compensation,
we need your claim number, your employer's name, the date of the
injury, and the name and address of the insurance carrier.
