July 30 , 2007
It is difficult to maintain a modern public health laboratory with constantly changing technology and testing methods when faced with increasing demands, rising costs, and steady-state resources. The Texas Department of State Health Services’ (DSHS) Women’s Health Laboratory (WHL) provides quality, cost-effective public health related laboratory testing and must recover costs for testing services whenever possible. Fees in your contract have not undergone significant revision in three years. It has become essential to revise our fees and realign them with service costs. The revised fees for WHL testing services will become effective September 1, 2007 and a copy is enclosed for your information.
If only requesting laboratory tests included on this fee list, a contract to obtain WHL services is no longer necessary as your former contract will terminate effective September 1, 2007. If your organization requires a contract to continue submitting specimens for WHL testing or you need services not included on this list, contact Alice Felix toll-free at 888/440-5002 or locally at 210-531-4596 or email Alice Felix.
It is important that the payor source for testing be indicated on the specimen submission form. Laboratory submission forms have more clearly marked payor information. For each specimen submitted, the appropriate payor must be indicated and applies to all payors: Medicaid, Medicare, private insurance, DSHS program, or other submitter. If information is incomplete or inaccurate, the submitter will be billed for testing. DSHS staff can assist with correctly completing the revised submission forms and identifying the appropriate payor.
The payor indicated on the submission form determines who is financially responsible for the charge. The submitter will be charged if:
- Complete information is not provided; or
- A program is selected that does not provide coverage for the testing requested; or
- A program is selected for which the patient is not eligible.
Information required to file claims with third- party payors is as follows:
- Patient Demographic Information
- Date of Specimen Collection
- Ordering Physician/Qualified Non-Physician Practitioner Information
(name, UPIN and NPI)
- Medicaid/Medicare Number (if applicable)
- Private Insurance Information (if applicable)
(Insurance Company Name/Address, Policy Holder Name and Relationship to the patient, Policy/Subscriber/ID Number, and if applicable; Group Name and Number).
There will be a 60-day grace period making payor source corrections. During this time, payor information incorrectly submitted on submission forms may be noted on the statement next to the patient name and charge, identify the correct payor, supply complete payor information, sign, date and return to:
Women’s Health Lab
Attention: Billing Branch - Building 533
2303 S.E. Military Drive
San Antonio, Texas, 78223
Please direct any billing questions you may have to:
Mary Spears 210-534-8857, ext 2358
Norma Viafranco 210-534-8857, ext 2349
DSHS recognizes the impact that these revised fees have on the health community and every effort has been made to keep fee increases to a minimum.
Please be assured that DSHS will continue to provide outstanding public health laboratory testing to protect Texas citizens. We look forward to continuing our partnership with you.
Susan U. Neill, Ph.D., MBA
Director, Laboratory Services Section