Client

• Clients receive monthly itemized invoices that are generated at the close of the last day of each month.  
• Invoices indicate date of service, patient name, referring physician, test(s) performed, CPT code, accession number, test code and the test price.  
• Errors or notification of transfers or re-billing must be brought to our attention within 30 days of the invoice date.
• Requests received after 30 days will not be processed.  
• Payment terms are net 30 days.  
• Purchase order numbers if provided are displayed on the invoice.

 
Third Party

• At client request, we will bill outpatient Medicare, State of Ohio Medicaid plans or other third party commercial insurers directly. 
• All information must be provided as outlined on the Test Request Form.
• An appropriate ICD-9 diagnosis code is required for each test ordered. 
• To avoid incomplete or misinformation, we recommend that a copy (front and back) of the patient's insurance card be attached to the Test Request Form . If the required information is incomplete, the client will be required to assume responsibility and will be billed for all charges. 
• Claims filed to the patient's third party carrier (except Medicare and Medicaid) that are unpaid for 60 days will be billed back to the patient. 
• Patients are responsible for annual deductibles, co-payments and any balance not covered by their insurance company. We accept assignment on Medicare and Ohio Medicaid billing. 
• The laboratory does not bill Medicaid for states other than Ohio.

 
Patient

• Clients may request that a patient be billed directly.  
• All information must be provided as outlined on the Test Request Form. If the required information is incomplete the client will be required to assume responsibility and will be billed for all charges.  
• Please advise your patients that they will receive a bill for laboratory services from Cleveland Clinic Laboratories; they are solely responsible for these charges, and payment is due upon receipt of their bill.  VISA® and MasterCard® are acceptable forms of payment.

 
CPT Coding
CPT Codes are provided (in the Test Directory) as a convenience to our  clients as guidance to assist you in billing. Since CPT codes are subject to  change at any time, it is your responsibility to verify their accuracy for the  test performed.

For tests that involve several component tests, the Test Directory attempts  to provide a comprehensive list of CPT codes for all of the possible  components of the test. However, only a subset of component tests may  be performed on your specimen. You should verify accuracy of codes  listed. When multiple codes are listed, select codes for the tests actually  performed on your specimen.

Clients are encouraged to consult the CPT Coding Manual published by  the American Medical Association and to address questions regarding the  use of any particular code to their local Medicare carrier.

Cleveland Clinic Laboratories does not assume  responsibility for  billing errors due to reliance on CPT codes listed in the Test Directory.


Credit & Collections

• Cleveland Clinic Reference Laboratory reserves the right to review credit reports from reporting agencies such as Equifax, TransUnion and Experian. 
• All invoices are due in full upon receipt and must be paid within 30 days from the date billed.  
• All claims, requests for adjustments, or notification of errors must be made within 30 days of the invoice date or charges are considered to be accepted.  
• Charges unpaid after 90 days are subject to collection. The purchaser will assume all collection expenses, attorney fees and court costs.

 
Fee Changes

Fees are subject to change without notification. Specific client fees are available by contacting Cleveland Clinic Laboratories Client Services at  800.628.6816 or 216.444.5755 or by email at ClientServices@ccf.org.

Advance Beneficiary Notice
The ordering physician is responsible for ensuring that lab procedures  requested are medically necessary by federal guidelines in order to bill  Medicare. The Medicare program will allow the laboratory to bill the patient for denied services only if an ABN form is completed and signed by  the patient. Under these circumstances, an ABN form must be submitted with the specimen. For additional information, please contact Cleveland  Clinic Laboratories Client Services at 216.444. 5755 or 800.628.6816.