Accounts that are billed monthly will receive an
itemized bill listing the patient's name, test performed, date of service, and
the fee.
Northern Plains Laboratory will bill patients
directly if complete billing information is provided on the Northern Plains
Laboratory test requisition form or through the NPL Connect (HVR) system at the
time the specimen is submitted. Please
advise patients to expect a bill from Northern Plains Laboratory.
The following information must be provided:
·
Complete
patient name
·
Date of
birth
·
Social
Security Number
·
Patient's
current address
·
Guarantor's
(insured) name if different from patient
·
Insurance
name, policy number and address
·
Include the
alpha prefix for each BCBS number
·
Referring
physician/provider’s first and last name
·
ICD-10 Codes (Diagnosis)
Northern Plains Laboratory accepts assignment for
laboratory procedures performed on Medicare/Medicaid patients. We will bill Medicare or the respective
agency for laboratory services performed on Medicare/Medicaid patients. Provide the following billing information on
the Northern Plains Laboratory test requisition form or enter in the NPL
Connect (HVR) system:
·
Complete patient
name
·
Date of
birth
·
Social
Security Number
·
Patient's
current address
·
Medicare HIC
# (9 numeric + 1 alpha suffix)
·
Medicaid ID # (9 digit)
·
Referring
physician/provider’s first and last name
·
ICD-10
code(s) or Diagnosis
·
Advance
Beneficiary Notice of Noncoverage (ABN) if diagnosis is not deemed medically
necessary per Medicare Policy
Clients for whom NPL bills Medicare will be
notified of Medicare’s National Coverage Determinations (NCD) and any Local
Coverage Determinations (LCD) as they are published.
Tests referred to another lab are noted in the
test dictionary (Production Lab). The
most common reference laboratories used are ARUP or Mayo Laboratories.
Document Number: BILL-146.001