St. Joseph Laboratory Services General Polices

Billing	St. Joseph Regional Laboratory offers patient, client or third party billing. For billing and laboratory compliance purposes, a laboratory requisition must be completed with the following information. Patient’s Full Legal Name, Address, SSN, Phone Number, DOB, Doctor, Diagnosis, Tests Ordered.
Outpatient Laboratory Requisitions	This requisition is designed with the new Organ/Disease Panels included. Use the requisitions when ordering outpatient laboratory tests. Please do not order laboratory tests using a prescription pad. Additionally, St. Joseph Outpatient Diagnostic Test Request Forms should only be used when a patient is having other diagnostic procedures performed as well as Laboratory tests.
Advanced Beneficiary Notice	An Advance Beneficiary Notice (ABN) is included on the requisition. The purpose of the ABN is to inform the patient that in some instances payment may be denied by their federally funded program. If this occurs the patient may be billed for the laboratory test. ABN statement on the laboratory requisition states as follows: "An ABN acknowledges that you personally and fully accept responsibility for the payment of laboratory tests if payment is denied by your federally funded program. An ABN is not routinely used and is limited to cases where ‘genuine doubt’ exists about reimbursement of the laboratory test ordered. You have been asked to read this information because there is a reasonable likelihood that the test(s) your doctor ordered will not be paid by your federally funded program."
Medical Necessity	In 1996, the Health Care Financing Administration (HCFA) announced its position on medical necessity. HCFA contends that all laboratory tests whether ordered individually, as part of the new AMA/CPT Organ and Disease Panels, or as part of a physician designed custom panel must be medically necessary. Medicare/Medicaid/Champus or other federally funded program will only pay for services that it determines to be medically necessary.
Coding	St. Joseph Laboratory Services requests that the physician submit either a narrative description of the symptom or the ICD-9-CM Diagnosis Code which in turn the laboratory will submit to the federally funded insurance program.
Custom Panels & Physician Acknowledgments	A custom panel may be created by the physician; however creation of a custom panel requires the physician to sign a Physician Acknowledgment which states that the physician will only order the custom panel when all tests in the panel are medically necessary. The St. Joseph Laboratory Outreach Coordinator MUST be contacted for the creation of custom panels.
Courier Services	Courier service is provided for specimen pickup at each facility and can be customized for individual needs. Couriers are trained in specimen handling and transport, and equipped with packing materials and cooling agents necessary to maintain specimen integrity. The courier may be reached by pager, cell phone or calling the main Laboratory number.
Supplies	Supplies necessary to submit specimens to St. Joseph Regional Laboratory are provided at no charge. However, Laboratory supplies can not be provided for client use or to be used to collect a specimen to be sent to another laboratory. The St. Joseph Regional Laboratory Compliance program does not allow for this occurrence. The U.S. Department of Justice, OIG, and HCFA consider this practice a kickback. OIG requires records to be maintained by the laboratory to show that if a supply is given to a client for specimen collection that a specimen is received by the Laboratory for testing.
Unacceptable Specimens	Occasionally a specimen is unacceptable for analysis due to improper collection, labeling, handling or transport. The client will be notified of any unacceptable specimen. If in doubt, please call the Laboratory for clarification of any specimen requirement before specimen collection has occurred.