DSI Billing is concurrent with the generation of test results.
Clients receive monthly itemized invoices for services.
There have been a number of recent changes in the payment
policies of the Medicare program. Under the current policy:
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Each individual test
component of an automated chemistry panel must be medically
necessary in order to qualify for reimbursement. However,
as a general rule, standard disease or organ panels
as defined by the Physicians’ Current Procedural
Terminology (CPT) (i.e. 80048 - 80076) are considered
individual tests. |
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Medicare will not
pay for non-FDA approved tests or for screening tests.
Medicare may pay for certain screening tests, with specific
diagnosis codes, at limited frequency. |
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If there is reason
to believe that Medicare will not pay for a test, the
patient must be informed of that fact prior to specimen
collection. The patient should then sign an Advance
Beneficiary Notice (ABN) to indicate that he or she
is financially responsible for the test if Medicare
denies payment. An example of the ABN form follows on
the next page along with detailed instructions for completion. |
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For specimens drawn
in physician’s offices, if required billing documentation
is not available, we are required to bill the physician. |
When ordering tests, please be informed that the physician
(or other authorized individual) is required to make an
independent medical necessity decision with regard to each
test the laboratory will bill. Additionally, the physician
(or other authorized individual) understands he or she is
required to (1) submit ICD-9 diagnosis code(s) at the highest
level of specificity, supported by the patient’s medical
record, as documentation of the medical necessity of the
tests ordered or (2) explain and have the patient sign an
Advanced Beneficiary Notice/Waiver Statement.
DSI bills and accepts assignment as payment in full from
Medicare, Medicaid and selected third-party payers.
DSI reserves the right to review credit reports from reporting
agencies (Dunn & Bradstreet, TRW, etc.). All invoices
are due in full upon receipt and must be paid within 30
days from the date billed. Charges outstanding after 90
days from invoice date are subject to collection, and all
collection or arbitration expenses, attorney’s fees,
and court costs will be borne by the purchaser. No terms
or conditions hereof may be changed except by written consent
of DSI Laboratories.
DSI clients may request a copy of their billing summary
by calling 239.561.8220.
All claims, requests for adjustments, or notification of
errors must be made within 45 days, or charges are
considered accepted by the client and liable for full
payment.
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