Billing Policies

Client Billing:

Clients will be billed at the end of each month and the itemized invoice will include the dates of service, patient/employee names, tests performed and fees.

Patient Billing:

Patients will be billed directly upon request; however, failure to provide the following information at the time the specimen is submitted may delay testing: 1) patient's name, address and zip code 2) patient's phone number 3) social security # 4) driver's license (state, number & exp. date) Please note that a billing service charge of $10.00 per test or panel will be added to the fees listed in the fee schedule. The billing service charge will be waived if payment is received in full at the time specimens are submitted for testing.

Third Party Billing

Pacific Toxicology Laboratories will bill insurance carriers only if adequate billing information is provided. Please note that the patient is personally responsible for all unpaid balances for laboratory services performed. Failure to provide the following information may delay testing:
(1) patient's name & address
(2) patient's phone number
(3) date of birth
(4) social security #
(5) drivers license (state, number, and exp. date)
(6) written diag. or ICD-9-CM code
(7) insurance co. name & address
(8) ins. co. phone number
(9) ID and Group number (or photocopy of the ins. ID card)
(10) direct payment authorization

2) Medicare:

Pacific Toxicology Laboratories will bill Medicare directly and accept assignment for covered services; however, some toxicology tests are not covered by Medicare insurance. NOTE: advise patients that if tests are not cove red by Medicare they will be billed directly. Failure to provide the following information may delay testing:
(1) patient's name & address
(2) sex & date of birth
(3) written diagnosis or ICD-9-CM code
(4) HIC (9 Numerics and 1-2 Alphanumerics/or copy of card)
(5) insurance co. name & address
(6) ins, co. phone number
(7) physician's state license number and UPIN

3) Workers' Compensation:

Workers's Compensation claims will be filed if all the required information is provided at the time the specimen is submitted for analysis. We will also file a lien. Failure to provide the following information may delay testing:
(1) patient's name & address
(2) patient's phone number
(3) date of birth
(4) social security #
(5) driver's license (state, number and exp. date)
(6) written diagnosis or ICD-9-CM code
(7) attorney's name & address
(8) attorney's phone number
(9) insurance co. & address
(10) ins. co. phone number
(11) ID & Group number (photocopy of ins. ID card if available)
(12) adjuster & claim number (if available)
(13) employer's name & address
(14) employer's phone number
(15) WCAB number
(16) date of injury & copy of first report of injury and diagnosis

4) Personal Injury:

The patient or their attorney may be billed directly in cases of personal injury, however, all tests must be ordered by a physician. In addition, we must have a signed lien in these cases. We recommend personal injury cases be prepaid at the time the specimens are submitted for testing. Failure to provide any of the following information may delay testing:
(1) patient's name & address
(2) patient's phone number
(3) date of birth
(4) social security #
(5) driver's license (state, number and exp. date)
(6) date of injury
(7) written diagnosis or ICD-9-CM code
(8) attorney's name & address
(9) attorney's phone number
(10) court name & address
(11) case name & number (if available)
(12) insurance co. name & address (if available)

5) Medicaid/Medi-Cal:

Environmental toxicology tests performed by Pacific Toxicology Laboratories are not covered under the Medi-Cal program. Cash prepayment is required prior to test performance. PTL is authorized to bill Medi-Cal for the state Child Health and Disability Prevention Program (CHDP) laboratory testing.

6) Medicolegal Billing:

Consultation, depositions, and special handling regarding specimen preparation, logistics, research, special reports, etc. will be billed at the rate of $300.00 per hour plus expenses independent of any test analysis fees. This fee must be paid before any action will be initiated. There is a one-hour minimum charge and time extending beyond that will be billed and itemized in fifteen-minute segments. Please contact our Vice President, Administration for details and to arrange utilization of these services.