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| Out of network laboratory work |
DILLIGAS |
05/04/04 |
Is it legal to absolve patients for monies due when their insurance company does not cover the total or even a portion of the testing performed by an independent laboratory?
Example:
Physician X performs a swab in an OB/GYN office for Chlamydia and send that swab to a laboratory for testing.
The laboratory performs the testing and submits results to Doctor and submits for payment to the patients insurance company.
The patients insurance company denies payment for out-of-network laboratory.
The laboratory does not pursue the patient for payment so tat they may keep the ordering physicians office as a client. (Assuming that the ordering physician is an ongoing; either contract or not, client of the laboratory.)
Is this a straightforward practice, or is it not allowed by some laws or other governing authority.
I am unsure of the statues or other regulations that are in place regarding this practice. However, I am aware of the OIG (Office of the Inspector General) prohibiting Professional Courtesy and other abuses that are fraudulent to retain referring physicians, and others in position to refer work.
What are some references that I can view on the web, or is there a resource for this specific instance that is mentioned in publications that can be viewed online.
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| Summary of Answers Received |
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1. www.irs.gov...
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08/11/05 |
katiy | |
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