Re: Billing Question

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From:"D. Hammer" <> (by way of histonet)
Date:Sun, 2 May 1999 03:25:31 -0400
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Hi Marg,

In the situation you describe, if the consult is a block sent that needs
preperations by the institution it was sent to, there would be a Hospital
Componant charge as well as a Pro Fee componant.  I would assume, altho
complicated internally, each would charge their own fee.

If it is strickly a slide consult, then there is no Hospital charge
allowable because the system designers provided no cpt code to assign.
(probably didn't understand the real world) The "group" would charge the
Pro Fee that was charged back to them.

Another problem also might exist, as the institution you send to may
charge you differently than your normal charge schedule for these which
forces you to have some sort of write in charge (not easily done
electronically) to recover what you have been charged by the institution
the consult was refered to.  Then, of course, is the situation of denied
payments by the insurance carrier(s) because the charge did not go with
the total bill for the patient stay at your Hospital and may be deemed
over due by the carrier or your institution.

It is a bad situation, because the Hospital is probably providing for the
staffing and supplies to send the materials out and can not recoup
expenses.  An agreement could be made with the "pathology group" to pay
the hospital for handling costs.

You have hit on a major reason I am taking early retirement!!  Hope to see
you in Palm Springs soon. :)  If we meet, lets talk about sun, and your
fantastic ways of celebrating your staff during Lab Week, not billing. :)

P.S Really interested in hearing other peoples thoughts on this question.

Don Hammer, Administrative Director            UNIVERSITY OF WASHINGTON
Hospital Pathology, Box 356100                     MEDICAL CENTER
1995 NE Pacific St.
Seattle Washington, 98195                  ~Where Knowledge Comes To Life~
(206) 598-6401 Fax: (206) 598-4928

On Sat, 1 May 1999, Hagerty, Marjorie A. wrote:

> I have a billing question for those of you who work in a hospital where the
> pathologists bill for their services.
> Our hospital bills for the technical component on all testing and the
> pathology group/pathologists bill for the professional component.
> My question is: If you are in a similar situation, do your pathologists bill
> for the consults that they send out? Or does the hospital?
> Thanks,
> Marg
> Marjorie Hagerty, H.T. (ASCP) H.T.L., Q IHC
> Supervisor, Anatomic Pathology
> Eisenhower Medical Center
> 39000 Bob Hope Drive
> Rancho Mirage, California 92270
> 760.773.2013
> FAX:760.773.1587

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