Print

Physician Billing Services

The ProPath companies that bill for medical services include:

  • ProPath Services, LLP
  • ProPath Associates

physician billingBills from ProPath Services are for outpatient laboratory testing (such as biopsies and Pap smears) performed at your physician's office or a surgery center as well as technical processing and consultations.

Bills from ProPath Associates, our hospital-based pathology practice, are for the professional services relating to laboratory testing performed at various area hospitals. If you recently had a hospital encounter (either inpatient or outpatient), you may very likely receive a bill from ProPath as our pathologists direct several hospital laboratories.

Our Laboratory performs specialized testing for physicians, hospitals and other pathologists to assist other doctors in making decisions regarding a diagnosis or treatment plan.

Pay Your Bill Online

Insurance List - See your sales or service representative for a current insurance list.

How to designate Physician Billing

How to designate Patient Billing

Billing to Medicare/Medicaid

To designate Third Party Billing

New Important PECOS Reminder

As you have probably heard, the Centers for Medicare and Medicaid (CMS) require all providers (e.g. physicians and non-physicians) who order and refer tests or services for Medicare beneficiaries to be enrolled in PECOS. Claims (your own as well as the receiving laboratory’s) will be denied if the ordering/referring provider is not enrolled in PECOS effective January 3, 2012.

 

We are writing you as a reminder to enroll in Medicare’s PECOS (Provider Enrollment, Chain, and Ownership System) before the end of 2011.

 

The following link may be referred to for additional information:

 


We appreciate your prompt attention to this matter so any services, including your own, ordered, referred and billed for a Medicare beneficiary is processed accordingly without delay.


Insurance List

 

ProPath is a participating provider with most insurance companies. Please note that contracts may differ between the ProPath organizations.

Please see your sales or service representative for a complete insurance list.

 

How to designate Physician Billing

 

If the physician would like to be billed for a particular patient's testing, please check "ACCOUNT" under the "BILL TO" section of the requisition or online order form. Each client is billed once a month with an itemized invoice. Payment is due within thirty (30) days.

For questions about your client bill: call 214-237-1665 or 800-654-1888 ext. 1665, M-F 9:00 a.m. - 5:30 p.m. C.S.T.

 

How to designate Patient Billing

 

At the physician's request, patients may be billed directly. If the patient should be billed, please check "PATIENT" under the "BILL TO" section of the requisition or online order form. Please be sure to provide complete patient name, address, city, state, zip code, and telephone number.

 

Billing to Medicare/Medicaid

ProPath is required to bill Medicare for all patients enrolled under Part B, when Medicare covers the testing services performed. For tests not covered by Medicare (e.g., some routine Pap screening), an ABN (Advanced Beneficiary Notice) must be completed by the physician's office and signed by the Medicare patient.

 

ProPath will also bill Medicaid as required.

The minimum information required for billing Medicare and Medicaid is as follows:

  • Patient Name
  • Patient Address
  • Patient Date of Birth
  • Patient Sex
  • Medicare/Medicaid Number
  • Referring Physician
  • Referring Address
  • ICD-9 Code
  • NPI Number

To designate Third Party Billing

ProPath is contracted with many insurance carriers. Please fill in the appropriate information on the test requisition (i.e. HMO, PPO, Medicare, etc.).


A copy of your office face sheet and the front and back of the patient's insurance card will ensure accurate billing. The minimum information required is as follows:

NOTE: Due to the fact that most Insurance Carriers allow only a short filing deadline, sufficient data to properly bill the Third Party Carrier is imperative. We will attempt to contact the physician's office for any missing information. If unsuccessful, the client will be invoiced and responsible for the cost of services rendered.