We want your care experience to be outstanding. We will take care of you and your concerns by offering in-depth testing, accurate results and innovative practices. Learn more about our pathology testing, service offerings and billing support.
What Is Pathology?
Anatomic pathology is the branch of medicine in which we study how diseases affect the organs and tissues of the body. Our goal is to identify abnormalities that can help diagnose disease to help your physician manage treatment. Anatomic pathology is also used to help identify and manage cancers, diseases, disorders and infections.
What Does a Pathologist Do?
Pathologists help care for patients every day by providing their doctors with the information needed to ensure appropriate patient care. They are valuable resources for other physicians 24 hours a day, seven days a week.
Medical billing is a complex system even for those who deal with it every day. There are many different insurance carriers, each with its own contract and terms of coverage. At CellNetix, it is our policy to work with our customers to reach swift and compassionate resolution of financial questions.
About one year ago, I got a very good pathology slide, and it was sent to your office for examination. Due to your skill and ability, my diagnosis was made. The follow-up was a needle biopsy and then surgical removal. We followed up with 34 radiation treatments. My physician said they never find cancer in the nipple discharge tests that are done in her office. Thank you for your diagnosis and educated skill that found my "suspicious cells." All cancer diagnoses are scary, but I am confident I am well and healthy." CellNetix Patient (Olympia)
When I came to Providence Centralia Hospital to have my bone marrow biopsy, it was performed by CellNetix Pathology. It was unexpectedly easy and relatively painless. I've had this procedure several times, and this one was the best." CellNetix Patient (Centralia)
What is this bill for?
A tissue or body fluid (pathology specimen) obtained at either a doctor's office or medical center and labeled with your name was submitted to the laboratory for evaluation. Our pathologists are the specialists who evaluate the pathology specimen and consult with your doctor as to whether the sample submitted contains any abnormality. You will receive separate billing statements from your treating physician and/or the facility where you were seen.
What is an EOB?
EOB stands for Explanation of Benefits. The insurance carrier sends the patient and the provider a form summarizing the insurance plan's coverage for a specific medical event (procedure, test or supplies). This is not a bill. You will receive billing statements from CellNetix for any patient responsibility amounts, such as coinsurance or deductible.
Why didn't you bill my insurance?
There are several reasons why you might receive a bill even though you have medical coverage:
• Missing Insurance Information: Our Billing Department may not have received complete insurance and patient information to submit a claim.
• Claim Denial: Sometimes the insurance carrier has been billed but the payment was denied. If the denial is the cause of your receiving a bill from CellNetix Pathology & Laboratories, please refer to the EOB (Explanation of Benefits) mailed by your insurance company. The EOB form states the reason(s) for the denial.
• Medicare Denial: If you are a Medicare patient, it is possible that payment for a Limited Coverage Test was denied. In those instances, the patient is responsible for charges whenever the patient has signed the Advance Beneficiary Notice before the specimen was collected.
How do I update you with my correct insurance information?
If you wish to submit billing information directly to our billing office, please contact our Billing Department at 877-340-5884, or you can email firstname.lastname@example.org.
Why did I receive two bills for the same service date?
It is an industry standard to separate the professional and technical components of many pathology services for reporting and reimbursement purposes. This billing methodology provides further cost transparency to both the patient and insurance payors as the two types of services are itemized.
Technical Component: These services represent the technical work that the lab performs including preparation of the specimen and processing of the tests.
Professional Component: These services represent the work performed by the pathologist who interprets your lab findings and renders his or her professional opinion, arriving at a diagnosis.
Do I pay more than if you billed it all together?
No. The reimbursement amount for the technical and professional components combined is equal to the payment we would receive if they were billed together.
Why did you bill the same CPT code more than once?
Common Procedural Terminology (CPT) codes are used to report medical services performed to insurance payors for reimbursement. In pathology, the same CPT code is sometimes used to report slightly different or separate procedures. For example:
• Biopsies: If your surgeon submitted five different specimens to CellNetix for evaluation, each biopsy will be separately reported for payment resulting in multiple identical CPT codes.
• Immunohistochemistry staining (IHC): If IHC staining was performed on your specimens, each antibody stain performed will be separately reported for payment. This will again result in the same CPT code being duplicated for each antibody used.
I received flow cytometry services. Why are so many units of service billed?
Flow cytometry is a valuable tool in the diagnosis and management of blood cancers, which are known as leukemia and lymphoma. The testing method measures the number of cells in a sample as well as certain characteristics of cells including the presence of normal and abnormal markers on the cell surface. Our CellNetix pathologists will review your clinical information and all pathological material available and order the appropriate flow panel as medically indicated. A panel includes multiple markers necessary to obtain the critical diagnostic and therapeutic information. After the technical staff performs the testing, the results of the panel are interpreted by our CellNetix pathologists.
How can I get a copy of my pathology report?
You can get a copy of your pathology report from your physician. Another option is to call your pathologist’s office (CellNetix Pathologists & Laboratories’ toll free number: 866-236-8296).
Can CellNetix review my pathology slides if the case was evaluated by a different hospital/pathology group?
Yes. While there is a small cost incurred with this type of review, we frequently review pathology cases from outside institutions.
Can I send my CellNetix Pathology case to another hospital/pathology group for a second opinion?
Yes. Again, a small cost is incurred with this type of review, but we are happy to facilitate such an “extra-departmental review.”
Is a pathologist available to speak with me about my CellNetix pathology report?
Yes! Please call our toll free number (866-236-8296) for additional information. Alternatively, you can call the pathologist who read your case directly. The phone number is typically listed below his/her name at the bottom of the report.
Can I review my pathology slides with a CellNetix pathologist?
Absolutely! Please call our toll free number (866-236-8296) for additional information.
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