Anatomic Pathology Consultation Services - Billing Information
Payment for Services - UPP Pathology
Consults with IHC'sFor 2016 our consults range in price from $150.00 to $650.00 based on the complexity of the case and includes IHC's performed.
Level One $150 slide only review
Level Two $250 consult and up to three special stains
Level Three $375 consult and up to 7 special stains
Level Four $ 550 consult and up to 11 special stains
Level Five $650 consult with more than 12 special stains
Note: This pricing is intended to be a general guideline. Final consultation charge is determined by the consulting pathologist and is based on pathologist time and complexity of case.
FISH and molecular testing are not included and are separate charges.
We have two methods of billing as follows:
Client Invoicing to Referring InstitutionFor consultation services to be paid by your institution, you will receive one bill for both the professional and technical services from the University of Pittsburgh Physicians Pathology Department (UPP). Invoices are issued by our finance department every two weeks and payment is due within 30 days of receipt. When an institution is invoiced directly, we do not provide corresponding CPT codes for the services. We will provide a copy of the completed pathology report for your coding staff to review and assign appropriate CPT codes. Our payment address is:
University of Pittsburgh Physicians
P.O. Box 7406
Pittsburgh, PA 15213
In addition to checks, we will accept all major credit cards. Please contact Pathology Finance at 412-648-2306 when paying by credit card. For credit card payments, please be prepared to provide the following: type of card (Visa, Mastercard, etc.), expiration date, credit card number, card holder's name, CVD number, and the address/fax number where the receipt is to be sent. Please be sure to provide identifying case information so the appropriate account is credited.
Third Party BillingComplete patient demographic and insurance information must be sent along with the specimen. UPP Pathology will attempt to bill the patient's insurance and collect payment. We must also be a participating provider with the insurance. UPP Pathology participates with Medicare and other major insurers, however, the submitting institution is responsible for verifying the insurance and coverage prior to sending. Please check with the patients insurance before sending the specimen for review. The NPI number of the referring physician is also required. We regret, but, at this time, we can accept only Pennsylvania, West Virginia, and Ohio State Medical Assistance.
If payment is denied by the patient's insurance, your institution will be invoiced for the services and will be responsible for payment. Please ensure that you or your institution informs the patient that they will be responsible for any co-pay, coinsurance, or deductible that their insurance may require.
Demographic material should include enough information to sufficiently register the patient. Demographics include the following: patient full name and date of birth, complete address and telephone number, insurance name and address, insurance ID number, group number, and complete address and contact telephone number. Please be HIPAA compliant when sending the information.
Fresh Tissue Specimens and Specialized TestingWe will attempt to bill fresh tissue specimens to the patient's insurance when we have received sufficient patient information and we are participating with the insurance. In the event that the service is denied, you will be responsible for payment of two invoices: one from the hospital where your specimen was submitted for testing for the technical component and one from UPP Pathology for the professional component.
All specialized testing (ordered without a consult) is billed directly to the submitting institution. For these services, please include with your paperwork your billing contact (person approving payment) along with their telephone number and billing address. In addition to checks, we accept all major credit cards. For credit card payments send the following: type of card (Visa, Mastercard, etc.), expiration date, credit card number, card holder's name, CVD number, and the address/fax number where the receipt is to be sent. Please see each specialty's web page for specifics on the technical component billing and pricing.
Download the Specimen Collection Requirements Manual, effective January 2016, here.