Billing and Reimbursement FAQ’s What insurances does DRUGSCAN ® accept and who are you in-network with? DRUGSCAN ® accepts all insurances. A list of the insurances that we are in-network with can be provided to you. Does this mean the patient won’t be charged? No. We bill patients in all cases, as required by all applicable regulations. It would not be appropriate for DRUGSCAN ® to not bill the patient. What types of things would a patient get billed for? For in-network patients, we bill the patient for the co-insurance, deductible, and/or co-payment amounts determined by the insurance company, just as our contract with the payor requires. Therefore, DRUGSCAN ® does not decide those amounts and they may vary for every patient, even if they have the same insurance company. For out-of-network (“OON”) patients, we generally attempt to bill an amount that approximates what the patient responsibility would be if we were in-network with that payer. However, there is an exception for patients residing in Florida, New York, Colorado, Idaho and South Dakota where state laws prevent us from billing in the previously mentioned manner and we must bill exactly what the Explanation of Benefits (EOB) states is patient responsibility. Patients may also get a bill when something is required from the patient for us to submit the claim to their insurance. These bills are mainly for informational purposes. My patients are complaining that they are getting huge bills from their insurance company. Why are they getting them? Most importantly, we need to make sure the patient is not referring to an EOB they received from their insurance company. An EOB certainly contains billing related information and can look like a bill to a patient. However, an EOB is NOT asking for payment and will include the list price for services – which has no bearing on what the patient is required to pay. The only thing the patient will ever be asked to pay is an invoice that has DRUGSCAN ® ’s logo on it. Can you guarantee that no large bills are going to go to the patients? No. The patient may receive a bill larger than normal if: 1. The patient has an unmet deductible that they must cover before their insurance will pay for services. 2. Payor contracts or state regulations require it. 3. DRUGSCAN ® has been unable to collect the information necessary to bill the patient’s insurance. In the latter instance, once the patient calls us to provide the missing information, we can submit our claim to their insurance company.
All codes have a maximum allowed of 20 days per calendar year; 80307, 80320- 80377, 83992, G0480, G0481, G0482, G0483.
Paramount
Presumptive Drug Testing
Definitive Drug Testing
HMO, PPO, Individual Marketplace, & Elite:
• 80307 allows only one unit per date of service. • G0480 allows only one unit per date of service. • G0481 allows only one unit per date of service. • G0482 allows only one unit per date of service. • G0483 allows only one unit per date of service. Advantage: • 80307 allows only one unit per date of service. • 80320-80377, 83992 allows only 5 tests within the code set listed per date of service.
Presumptive Drug Testing
Definitive Drug Testing
The frequency limitation of 18 dates of service for presumptive drug tests and 18 dates of service for definitive drug tests.
United Healthcare Commercial
Presumptive Drug Testing and Definitive Drug Testing
Vermont Medicaid
Presumptive and Definitive testing
The allowed frequency for both presumptive and definitive drug testing is 20 in a calendar year.
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For questions call billing customer service at 844.345.1821 or email patient.billing @ DRUGSCAN.com
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