Frequently Asked Questions
Medical billing is a complex system even for those who deal with it every day. There are so many insurance carriers and so many insurance contracts. Each contract has its own terms and the terms of coverage may vary from patient to patient. Added to the confusion is that a person’s carrier might change with a change in circumstance. For example, an employer may change carriers, the patient may have a change in employment and some people have both primary and secondary insurance coverage. To assist in the interpretation of our invoice and for patient convenience we have published definitions of words and terminology in our Glossary.
Following are answers to our most frequently asked billing questions.
Who are you?
What is this bill for?
What is an “EOB”?
Why didn’t you bill my insurance?
There are several explanations why you might receive a bill even though you have medical coverage:
- Perhaps our billing department did not receive the complete insurance information or patient details for us to submit a claim.
- Sometimes the insurance carrier has been billed but the payment was denied. If a denial is the cause of your receiving a bill from PCSB, please refer to the EOB (Explanation of Benefits) mailed by your insurance company. The EOB form states the reason(s) for denial.
- If you are a Medicare patient, it is possible that payment for a Limited Coverage Test was denied.
- If you wish to submit billing information directly to our billing office, please see Billing Contacts.
- Some insurance companies (BC/BS), prefer us to bill you directly. In these cases, your insurance company sends payment to you directly. They transfer reponsibility to you to pay our bill.
Why didn’t my insurance company cover the entire amount?
Some insurance plans do not cover all of the pathology services rendered. When this occurs, Pathology Consultants of South Broward, LLP bills the patient for the remaining copayment, deductible or balance due. If you believe that your insurance company erred in processing your claim, please call the billing service at 1.866.766.8870 whose representatives will work with you to assess coverage issues and assist you in interpreting your insurance carrier’s payment determination.
What does “deductible” mean?
The deductible is the amount of money in a calendar year that the patient must pay before the insurance will start paying. The amount varies according to the contractual terms of the individual insurance policy.
How can I modify my personal billing information?
You may call our billing department: 1.866.766.8870