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GML offers the following billing options:

1. Contracted Client Billing

GML clients will receive monthly itemized invoices for services provided. To avoid errors in billing, request sheets must be properly filled out with complete patient demographic and client information.

2. Patient Billing

GML can bill the patient directly if complete billing information is provided on the test requisition form at the time the specimen is submitted. If you have arranged for GML to bill directly, please advise the patient to expect a bill from Geisinger Medical Laboratories.

On the test requisition form please include:

  • Patient's full name
  • Patient's current address
  • Patient's current telephone number
  • If appropriate, guardian's (responsible party's) full name, address and phone number

3. Insurance (Third Party) Billing

When possible, GML will bill the patient's insurance company directly. Here is a list of the insurances that GML accepts. Below is a list of the information we require for various insurance providers.

  Geisinger Health Plan Blue Cross / Blue Shield Medicare Medicare Replacement Medicaid Commercial Patient Self-Pay
Full Name X X X X X X X
Sex X X X X X X X
Date of Birth X X X X X X X
Address X X X X X X X
Phone Number X X X X X X X
Relationship to Subscriber or Guarantor X X X X X X X
Medicare Number     X        
Medicaid Number         X    
Contract / Policy Number X X   X   X  
Group Number X X          
Plan Code   X          
Insurance Company Name              
Insurance Company Address       X   X  
ICD-9 Diagnosis Code X X X X X X  

 

Contact information:

If you have any questions, please contact a member of our billing team:

Billing Supervisor
Sarah Olshefsky
570-214-5663

Revenue Management Practice Consultant
Mike Reynolds
570-214-7731

Geisinger Billing Office
800-640-4206

Online laboratory billing reference information:

Medicare National Coverage Determination (NCD) - CMS Website: This is a resource to determine which diagnosis codes are considered medically necessary for Medicare. Many carriers follow Medicare's guidelines for medical necessity. Clients are advised to check the site at least quarterly for updates and changes in policy.
 

Frequently Asked Billing Questions

Is this bill correct?

If you feel there is an error with the bill that you have received, please call Geisinger Patient Billing at 800-640-4206.

Why are they calling me?

If you receive a call from one of the GML Insurance Specialists it is because we are missing valuable information to process your claim accurately.

Can you bill my office rather than my patients?

Yes, if your office prefers that GML bill you directly please contact your customer care rep. GML has the ability to bill laboratory services to your facility directly or bill your patients' insurance.

Is this diagnosis appropriate?

If you do not provide a diagnosis code or if you provide a code that is not considered medically necessary by Medicare guidelines, GML will contact your office and attempt to obtain a valid diagnosis. A diagnosis code must be provided for every specimen submitted to GML for testing.

What will I see if GML bills my office directly?

If you choose to have your office billed directly by GML, rather than GML billing your patients, you will receive an itemized statement including date of service, patient name, test performed, CPT code and test price. This statement will be sent out monthly. If GML is billing your facility you will receive a monthly invoice that includes date of service, patient name, test performed, CPT code and test price.

What is the best way to get accurate insurance data to GML?

A copy of the front AND back of the patient’s insurance card is the best way to ensure that your patients insurance will be billed correctly on the first submission.

Why do I have to send this insurance information again?

GML creates a new encounter each time a specimen is received on a patient. We need a copy of the front and back of the insurance card each time a specimen is sent to ensure accurate billing. We need insurance information with every specimen, because each invoice is treated as a new bill. We do not keep a file on individual patients.

This patient's insurance is not on the covered list – what do I do?

GML will accept non-par insurances if and only if a valid referral is in place prior to testing. If you have questions regarding covered insurances, please call one of the GML Insurance Specialists.

What is a Medicare Advantage Plan?

When a patient is eligible for Medicare they have the option to have a Medicare Advantage Plan. When this option is selected, the Advantage Plan is now the patient's primary insurance coverage and replaces the patients traditional Medicare A & B. The patient should no longer have a Traditional Medicare A & B Card.

What is a Medicare Supplement?

When a patient is eligible for Medicare they have the option to have supplemental insurance for gap coverage. When a patient has Medicare as well as any supplemental products, Medicare is primary and the supplement is always secondary coverage.

Where can I get a price estimate for my lab work?

See Geisinger's price estimator tool.