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Patient Information
Customized Services Include
BILLING CALL CENTER FACTS

As a courtesy, FirstSource Laboratory will gladly file to your insurance carrier given we have the necessary information to do so.

The information required to file a claim:

  • Insured’s Name
  • Insured’s Social Security Number
  • Insured’s Date of Birth
  • Insurance Company Name
  • Insurance Claims Filing Address
  • Insurance Policy Identification Number
  • Insurance Policy Group Number
•Although FirstSource Laboratory will do everything possible to get the correct reimbursement from your insurance carrier, the bill is ultimately the patient’s responsibility.

•FirstSource Laboratory cannot legally release lab results directly to the patient. Lab results can be obtained by the doctor who ordered the test(s).

•FirstSource Laboratory bills with the diagnosis provided by the referring doctor. FirstSource cannot change the diagnosis for any reason. ONLY the ordering doctor can supply a diagnosis.

•FirstSource Laboratory accepts VISA/ MasterCard/ Check/ or Money Order.

•Why has my doctor ordered these tests? Your doctor feels the tests ordered are clinically necessary to provide comprehensive healthcare. Laboratory testing, although expensive at times, has been proven to assist in the early detection and prevention of diseases and other serious health problems.

•Why is FirstSource billing me? FirstSource Laboratory Solutions, Inc. received a test(s) order directly from your physician to perform the testing indicated on your statement. This bill is separate and exclusive from any bills you may have received directly from your physician’s office. You as a patient are responsible for paying all applicable in-network deductibles, co-insurance and testing not covered by your insurance carrier.

•Can I pay my bill in monthly installments? FirstSource will consider monthly payments depending on the amount due for extreme hardship situations. Please contact our call center to inquire further.

•Why am I being billed for duplicate tests? FirstSource bills insurance carriers using Common Procedural Terminology (CPT) codes. Thus, it is not uncommon to have multiple CPT codes billed for the same date of service.

•Why was my account turned over to collections? FirstSource provides ample opportunity for patients to resolve balances before being sent to collections. If we have not had a response to several invoices, letters, and phone calls, your account will be turned over to a collection agency.

•Why do your office personnel always ask for my name, address, date of birth or social security number either when I call in or they call me? Your personal information is private and confidential. Due to Federal HIPAA Guidelines our office personnel are doing everything possible to verify that we are only speaking to the patient/ guarantor of the account.

•Why can you not speak with my spouse about my bill? Due to Federal HIPAA Guidelines account information can only be discussed with the patient/ guarantor of the account unless a Release of Information Form is signed by the patient and on file with FirstSource Laboratory.

FINANCIAL HARDSHIP

Financial assistance is available for extreme hardship situations. When you request financial assistance from FirstSource Laboratory Solutions, Inc. you will need to fill out the Financial Hardship Questionnaire. The form must be completely filled out (both pages) and signed. Forward the completed form to the office with a letter explaining why you believe your situation warrants financial assistance, a check or money order for $25.00 (towards the account balance), and proof of income.

When the form is received in the office, it will be reviewed by management to see if financial assistance is warranted. Within 2 weeks of receiving the hardship request management will make a decision and a letter will be sent to the patient explaining the decision. The assistance is based on Federal Poverty Guidelines and personal financial situation.

2007 Poverty Guidelines for the 48 Contiguous States and the District of Columbia:

Persons in Family Poverty Guideline
1 - $10,210
2 - $13,690
3 - $17,170
4 - $20,650
5 - $24,130
6 - $27,610
7 - $31,090
8 - $34,570

Assistance may be given by discounting the balance and/ or reducing the minimum monthly payment plan.

CLICK HERE TO DOWNLOAD THE FINANCIAL HARDSHIP FORM 
 

Send correspondence to:
FirstSource Laboratory Solutions, Inc.
PO Box 50419
Indianapolis, IN 46250

•Hours: Monday-Friday 9:00am-4:00pm EST

•Phone: 317-566-9846 option #2
•Fax: 317-284-5296

 
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