Pacific Toxicology Laboratories

Third Party Billing

It is necessary to maintain complete patient notes for test ordered and medical necessity. Frequently, providers will request patient notes for review.

I. Private Insurance

Pacific Toxicology Laboratories can bill insurance carriers if the following billing information is provided:
(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-10-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

II. Medicare/Medicaid/Tricare

Pacific Toxicology Laboratories can bill government providers for covered services. Please provide the following billing information along with the specimen:

(1) patient's name & address
(2) sex & date of birth
(3) written diagnosis or ICD-10-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, NPI number, and Pecos registered
(8) physician signature

III. Workers' Compensation:

Workers Compensation claims will be filed if all the required information is provided at the time the specimen is submitted for analysis.

(1) patient's name & address
(2) patient's phone number
(3) date of birth
(4) date of injury
(5) social security number
(6) driver's license (state, number and exp. date)
(7) written diagnosis or ICD-10-CM code
(8) attorney's name & address
(9) attorney's phone number
(10) insurance co. & address
(11) ins. co. phone number
(12) ID & Group number (photocopy of ins. ID card if available)
(13) adjuster & claim number (if available)
(14) Approve RFA

IV. 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 number
(5) driver's license (state, number and exp. date)
(6) date of injury
(7) written diagnosis or ICD-10-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)

V. Medicolegal Billing:

Consultation, depositions, and special handling regarding specimen preparation, logistics, research, special reports, etc. will be billed at a predetermined hourly rate, 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.