Foundation for Blood Research (FBR): Resource Guide-Billing Policies

Billing Policies

General requirements

Requirements for each type of billing are listed below. Refer also to the Billing Table.

Client Billing

FBR will bill the hospital, reference laboratory, institutional client, clinic, or medical group as a client on a monthly basis, unless other arrangements are made. All bills are due and payable upon receipt. If you have any questions pertaining to your account please call the Business Office. Discrepancies in billing must be reported to the Business Office within 30 days of the invoice date.

Patient Billing

Direct Patient Billing is available to Maine outpatients only. If you request patient billing, complete the Billing and Patient sections on the test requisition form at the time the specimen is submitted. Providing initial accurate information will eliminate follow-up correspondence to you from our Business Office. If you have arranged for FBR to bill the patient directly, please inform the patient that he/she will be receiving a bill from FBR. The patient is solely responsible for the charges. Patient bills are due 30 days from receipt.

General Insurance

FBR will bill insurance companies on behalf of the patient if complete billing information is provided on the test requisition form. All requests for third party billing must include information indicated in the "Other" column of the Billing Table.

Medicare

FBR will accept Medicare assignment. Please provide, the following:

Medicare HIC number (9 numbers + 1-2 alpha)
Advance Beneficiary Notice may be required for tests printed in red (Please refer to Test Requisition)
Individual Test components must be checked off for Profile tests

Medicaid

FBR is currently a provider for the Medicaid programs of Maine and New Hampshire. In those states in which FBR is not a provider, it is the sender's responsibility to inform patients that they will be billed by FBR and will be solely responsible for the charges.

Blue Cross/Blue Shield (BC/BS)

If your patient is covered by BC/BS, FBR will bill BC/BS directly. Please provide:

BC/BS certificate number
BC/BS group number
BC/BS subscriber's number and name if different from patient's
The State in which the BC/BS patient is insured

If the claim is for Empire BC/BS or BC/BS of New York, please include the complete address of the Claim Office.

Billing Table

Bill To:
	Client	Patient	Medicare	Medicaid	Other	Worker's Compensation	Blue Cross
Patient Name	R	R	R	R	R	R	R
Billing Address		R	R	R	R	R	R
Date of Birth	R	R	R	R	R	R	R
Sex	R	R	R	R	R	R	R
Referring Physician	R	R	R	R	R	R	R
NPI, Referring Physician or facility			R	R	R	R	R
Diagnosis/ICD-9 code	D	R	R	R	R	R	R

Sender's Address	R	D	D	D
Guarantor if other than patient		R	R	R	R	R	R
Subscriber					R		R
Soc. Security No.		D	D	D	R	R
Place of Employment					R	R
ID/Certificate No.			R	R	R	R	R
Insurance Name					R	R
Group No.					R	R	R
Insurance Address					R	R
Advanced Beneficiary Notice (ABN)			R*	R*

R= Required D= Desired

* An ABN is required when the provided diagnosis is not consistent with Medicare's definition of medical necessity. Please refer the client copy of the local carrier policy section on the back of the test requisition. Instructions are available for completing an ABN

Professional courtesy

Federal and state regulations prohibit offering "professional courtesy" testing; therefore, we cannot honor requests for this service.

Indigent testing

Requests for reduced laboratory charges on the basis of patient indigence must be made by the physician. Typically, any reductions allowed by FBR will be no more than the reduction allowed by the physician for his/her services.