Re: Billing Question

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To:"Weems, Joyce" <>
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At York Hospital, we bill the patient using the CPT code(s) supplied by
the reference lab.  We add overhead costs to the charges from the
reference lab.

We have been approached by various reference labs to allow them to bill
the patient directly.  Our Compliance Officer interprets the Medicare
rules to mean that only one bill - generated by the hospital - should be
received by each Medicare benefit recipient for services rendered during a
hospital stay.  Although this only applies to inpatient care at the
moment, APC regulations for outpatient Medicare recipients are not
far behind. We have decided this is the way to go for all of our patients
- regardless of payor class.  

I am anxious to hear how others handle this issue.

Candra Garver, MT(ASCP)
Manager - Anatomic Pathology
York Hospital
York, PA USA

On Tue, 23 May 2000, Weems, Joyce wrote:

> Is there a regulation regarding what should be billed for a reference test
> not performed in your facility? Are we allowed to only bill the patient what
> we are billed by the reference laboratory? If so - could you point me to the
> written regulation? Many thanks, j
> Joyce Weems	
> Pathology Manager
> Saint Joseph's Hospital of Atlanta
> 404-851-7376
> 404-851-7831 - fax

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