FAQ Billing Questions

I have a question about my bill, whom should I contact?

Please contact any of our Billing Department staff members to address and answer any questions you may have. Please refer to the State Listings above to contact the Billing Department of the Sonic Healthcare USA Anatomic Pathology Practice that performed services. If you have to leave a message your call will be returned within one business day.

Why did I receive a bill from a Sonic Healtchare USA Anatomic Pathology Practice?

Your physician has performed a procedure that requires the services of a pathologist. Our Sonic Healthcare USA Anatomic Pathology Practice is the practice your physician selected to provide the interpretation of your specimen. We are a separate entity from your physician which is why you received a separate bill from us. Our Sonic Healthcare USA Anatomic Pathology Practice is an independent practice offering high-quality, specialty-focused pathology services to many medical specialists and their patients across the United States. A pathology report will be sent directly to your physician to assist him/her with your care. Your physician will not bill you for our services.

Why have I received a bill when I have insurance coverage?

Many plans require the patient to pay a portion of his or her bill in the form of copays, coinsurance or deductibles.  We will follow the Explanation of Benefits (“EOB”) from your insurance carrier and bill according to their instructions.  In some instances, we were not provided with your insurance information. If your statement does not show your insurance information, or if the insurance information is incorrect, please contact our billing office. A billing specialist will obtain all necessary information and file your claim accordingly. It is important to notify our office promptly so that all insurance filing deadlines can be met.

I paid my co-pay at the doctor’s office. Why have I received a bill from a Sonic Healthcare USA Anatomic Pathology Practice?

Your physician has performed a procedure that requires the services of a pathologist. Our Sonic Healthcare USA Anatomic Pathology Practice is the practice your physician selected to provide the interpretation of your specimen. We are a separate entity from your physician which is why you received a separate bill from us.  Copayments typically cover physician office visits. Any patient responsibility, normally a deductible and/or coinsurance payment, based on your member agreement with your health plan will be billed to you once your health insurance has processed your claim. This will be reflected on your billing statement as well as your Explanation of Benefits.

I have a secondary or supplemental insurance policy. Will the Anatomic Pathology Practice Division file those claims for me?

If you provided a secondary insurance card, and there is a balance owed after the primary insurance company processes the claim, then we will submit that balance to your secondary carrier. If your secondary insurance has not been billed, please contact our billing office and we will submit to your insurance.  If your statement does not show your secondary information, or the insurance information is incorrect, please contact our billing office. A billing specialist will obtain all necessary information and file your claim accordingly. It is important to notify our office promptly so that all insurance filing deadlines can be met. Note: Secondary insurance policies may or may not cover everything the primary insurance does not cover.  You may still get a bill once both insurance plans process.

GENERAL BILLING INFORMATION

Billing Information

Your physician has performed a procedure that requires the services of a pathologist. A Sonic Healthcare USA Anatomic Pathology Practice is the laboratory your physician selected to provide the interpretation of your biopsy and/or specimen. Our Anatomic Pathology Practice is an independent practice offering high-quality, specialty-focused pathology services to many medical specialists and their patients across the United States. A pathology report will be sent directly to your physician to assist him/her with your care. Your physician will not bill you for our pathology services.

Patients will be billed separately for pathology services. Our Sonic Healthcare USA Anatomic Pathology Practice will submit charges for our services to the patient’s primary and secondary insurers. We will bill all insurances for patients even if we are not participating providers in the patient’s health plan. Our Sonic Healthcare USA Anatomic Pathology Practice will accept assignments on all insurances. We offer a self-pay prompt pay discount, and financial hardship policies are available for indigent patients. Patients can set up payment plans by calling our office. Credit card payments are accepted, and patients can also make their payments online.
If your statement does not show your insurance information, or if the insurance information is incorrect, please contact our billing office. A billing specialist will obtain all necessary information and file your claim accordingly. It is important to notify our office promptly so that all insurance filing deadlines can be met.

Some patients may see two EOBs from their insurance company, similar to what happens if laboratory services are rendered at a hospital. 

Once we hear from your insurance company, subsequent statements will reflect any payments made by them, as well as applicable managed care discounts and any remaining patient balance. You will continue to receive monthly statements for 90 days. Please see the section on payment for information on methods to pay your balance. Terms of payment are net 30 days. Ultimately, it is the patient’s responsibility to pay for services.

If no insurance is applicable, charges will be due upon receipt of the statement. If you have additional questions or concerns regarding your statement, please feel free to call our billing office for prompt attention to your concerns. Our knowledgeable and friendly staff is available to answer any questions you may have concerning our billing practices. Please have your insurance card, EOB from your insurance company, or billing statement available so our Billing Representative may assist you.
 

 

Compliance and Medical Necessity

Our Sonic Healthcare USA Anatomic Pathology Practice adheres to applicable federal and state laws, as well as the coverage limitations of private health plans. We are committed to complying with the law, and expect all our referring physicians to abide by the law as well.

Coding

CPT and ICD coding references provided by our Sonic Healthcare USA Anatomic Pathology Practice on your pathology report are provided only as a guidance to assist you in billing. Occasionally, an incorrect CPT or ICD code is chosen by a non-Medical Biller. Our Sonic Healthcare USA Anatomic Pathology Practice assumes no responsibility for billing errors due to reliance on the CPT or ICD codes we provide your office. It is your responsibility to verify the accuracy of the codes provided and to assign values to each code based on the guidelines of your practice.

For further information on CPT coding, please consult the CPT Coding Manual published by the American Medical Association. For further information on ICD coding, please consult the current ICD Coding Manual published by the World Health Organization (WHO).

Professional Courtesy Testing

Federal and state regulations prohibit healthcare providers from offering “professional courtesy” testing. As a result, we are prohibited from honoring professional courtesy requests. If your patient cannot afford our services due to financial hardship, please contact our Billing Department.