If you feel there is an error with the bill that you have received,
please call GML. The Client Services Representative will be happy to put
you in touch
with the billing department. Call 1-800-695-6491. (top)
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. (top)
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. (top)
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. (top)
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. (top)
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. (top)
When selecting an appropriate diagnosis code for a patients lab work,
be sure to check to see if the ICD-9 code needs a 4th or 5th digit specificity.
These end digits provide a greater specificity of the health condition
and are necessary for payment. (top)
789.0 Abdominal Pain requires a 5th digit which specifies that area
of pain.
789.00 Unspecified
789.06 Epigastric
789.07 Generalized 780.7 Malaise and fatigue requires a 5th digit
780.71 Chronic fatique syndrome
780.72 Functional quadriplegia
780.79 Other malaise and fatigue (top)
585 Chronic Kidney disease requires a
4th digit.
585.1 Chronic Kidney disease, stage 1
585.2 Stage II (mild)
585.3 Stage III (Moderate)
585.4 Stage IV (Severe)
585.5 Stage V
585.6 End stage renal disease
585.9 Chronic kidney disease, unspecified (top)
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. (top)
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. (top)
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 patients primary insurance coverage and replaces the patients
traditional Medicare A & B. The patient should no longer have a Traditional Medicare
A & B Card. (top)
When a patient is eligible for Medicare they have the option to have
supplemental insurance for gap coverage. When a patient had Medicare as well
as any supplemental
products, Medicare is primary and the supplement is always secondary coverage. (top)
Medicare will pay for a screening PSA as a preventative
service (for details see the frequency
guidelines link). When the screen
is being done
for this
purpose you should order GML code PSAS. If a PSA is being done for
diagnostic reasons you should order GML code PSA. (top)
