Hal, et. al,

Altho Medicare is an important subject, billing in general seems to be
a big question in the minds of alot of Pathology Labs.  I can't tell you
how many questions I have TRIED to answer.  I'm not a guru and think any
help people can get will be well worth it.

Beth Shepperd, Convention Workshop Coordinator, are you out there hearing
us? Kerry Crabb? Kim Simmons?

Don





~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~
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) 548-6401 Fax: (206) 548-4928
~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~


On Wed, 25 Nov 1998, Hawkins, Hal wrote:

>
> Another good speaker on this subject is Charles B. Root, Ph.D.,
> Venture Resources, West Dundee, IL, who gave a good talk on
> Medicare compliance issues at the Southern Medical Association
> pathology section meeting last weekend in New Orleans.
>
>  ----------
> From:  D. Hammer
> Sent:  Wednesday, November 25, 1998 8:12 AM
> To:  Weems, Joyce
> Cc:  'Histonet'; 'Hagerty, Marjorie A.'; Sumiko Sumida
> Subject:  RE: Medicare Billing
>
> Joyce,
>
> In a perfect world, the consulting pathologist will get permission from
> the refering institution to run additional special or immunos.  As a
> matter of fact,the consultant needs to have a record of the order from
> your institution in order to be "legal" in their billing. (if they bill
> insurance companies)
>
> We have the same problem here, but more so, we are remiss in getting the
> permission from the refering institution and giving them info to bill
> with.  We do alot of direct insurance billing as opposed to billing the
> institution, but that will change with the Medicare patients.  We are
> working on the staff getting permission to run additionaals.
>
> Don't you think, as I do, that NSH should have Dennis Padget (Padget
> Associates) give a half or all day workshop on Pathology billing.  People
> would be amazed at how complex it is and how many things are not done
> correctly.  My god, there are still people billing for slides and/or
> blocks.
>
> Don
>
>
>
>
>
>
> ~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~
> 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) 548-6401 Fax: (206) 548-4928
> ~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~
>
>
> On Tue, 24 Nov 1998, Weems, Joyce wrote:
>
> > Hi Margarie and all!
> > I have been mulling over this billing thing for over a year and am
> still
> > confused!!! I have asked our legal department about it and they are
> > confused!!!
> >
> > Our biggest problem has been with consults, which is what I am trying
> to
> > change. If we send out consults and bill the patient from our
> > institution, we often incur more charges when the consulting
> pathologist
> > does additional  special stains or immunos. We then can not collect
> > those charges, because it has been too long past the date of service.
> > Now, granted, the biggest problem is with Medicare, (our census is ~65%
> > Medicare!), but insurance companies are also beginning investigations
> so
> > that everything is under scrutiny. The problem is that Medicare charges
> > FRAUD instead of error!
> >
> > I am looking forward to what answers we are going to come with!
> >
> > HAPPY THANKSGIVING EVERYONE!
> > Joyce
> >
> > >----------
> > >From:  Hagerty, Marjorie A.[SMTP:mhagerty@emc.org]
> > >Sent:  Monday, November 23, 1998 8:18 PM
> > >To:  Histonet
> > >Subject:  Medicare Billing
> > >
> > >
> > >Hi Everyone,
> > >
> > >After reading Joyce Weem's explanation concerning medicare billing
> > >requirements, I find myself very confused. I am, however, less
> confused
> than
> > >I was before I read it! I am beginning to think that I am making some
> > >illegal billing decisions. (Oh, no!)
> > >
> > >My question is this - Where can I find out more information on this?
> What
> > >can I read?
> > >Is anyone willing to explain this to me in a phone conversation?
> Joyce?
> Any
> > >billing experts?
> > >
> > >All help and direction will be greatly appreciated. I don't want all
> > >reference laboratories to bill us because I know we will lose money. I
> would
> > >like to have the reference laboratory bill whenever it is legal.
> > >
> > >Marg
> > >Rancho Mirage, CA, USA
> > >mhagerty@emc.org
> > >
> > >
> >
> >
>
>
>
>