Physician Billing Services
The ProPath companies that bill for medical services include:
- ProPath Services, LLP
- ProPath Associates
- ProPath Laboratory, Inc.
 Bills from ProPath Services are generally for outpatient laboratory testing (such as biopsies and Pap smears) performed at your physician's office or a surgery center.
Bills from ProPath Associates, our hospital-based pathology practice, are for the professional services relating to laboratory testing performed at various area hospitals. If you recently had a hospital encounter (either inpatient or outpatient), you may very likely receive a bill from ProPath as our pathologists direct several hospital laboratories.
Bills from ProPath Laboratory are generally for sophisticated testing performed to assist other doctors in making decisions regarding a diagnosis or treatment plan. Our ProPath Laboratory performs specialized testing for physicians, hospitals and other pathologists.
How to submit your New NPI
Insurance List - See your sales or service representative for a current insurance list.
How to designate Physician Billing
How to designate Patient Billing
Billing to Medicare/Medicaid
To designate Third Party Billing
How to submit your New NPI
Effective May 23, 2007, healthcare providers are required by the HIPAA Act of 1996 to use their new National Provider Identifier (NPI) for electronic health care transactions. However, Medicare will start accepting NPIs, October 2, 2006. NPI will replace ALL provider identifiers, including UPIN, and will follow that provider for life.
If you have received your new 10-digit NPI number, please let us know of the new identifier via:
- Online at NPI Update. Forgot your user ID and password? Contact your ProPath representative or CRC at 214-638-2000 or 1-800-258-1253.
- Call 214-638-2000 or 800-258-1253, ProPath Client Response Center
- Email
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with provider’s name, ProPath account number, UPIN and new NPI.
- Fax completed NPI Client Update Form to 214-237-1731
- Mail completed NPI Client Update Form to:
ProPath
Attn: CRC
1355 River Bend Drive
Dallas, TX 75247
Have more questions about NPI? Go to https://nppes.cms.hhs.gov/ or call 1-800-465-3203, NPPES Customer Service, for more information.
If you have questions for us, please contact our Client Response Center at 214-638-2000 or 800-258-1253.
Insurance List
ProPath is a participating provider with most insurance companies. Please note that contracts may differ between the ProPath organizations.
Please see your sales or service representative for a complete insurance list.
How to designate Physician Billing
If the physician would like to be billed for a particular patient's testing, please check "ACCOUNT" under the "BILL TO" section of the requisition or online order form. Each client is billed once a month with an itemized invoice. Payment is due within thirty (30) days.
How to designate Patient Billing
At the physician's request, patients may be billed directly. If the patient should be billed, please check "PATIENT" under the "BILL TO" section of the requisition or online order form. Please be sure to provide complete patient name, address, city, state, zip code, and telephone number.
Billing to Medicare/Medicaid
ProPath is required to bill Medicare for all patients enrolled under Part B, when Medicare covers the testing services performed. For tests not covered by Medicare (e.g., some routine Pap screening), an ABN (Advanced Beneficiary Notice) must be completed by the physician's office and signed by the Medicare patient.
ProPath will also bill Medicaid as required.
The minimum information required for billing Medicare and Medicaid is as follows:
- Patient Name
- Patient Address
- Patient Date of Birth
- Patient Sex
- Medicare/Medicaid Number
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- Referring Physician
- Referring Address
- ICD-9 Code
- UPIN Number
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To designate Third Party Billing
ProPath is contracted with many insurance carriers. Please fill in the appropriate information on the test requisition (i.e. HMO, PPO, Medicare, etc.).
A copy of your office face sheet and the front and back of the patient's insurance card will ensure accurate billing. The minimum information required is as follows:
NOTE: Due to the fact that most Insurance Carriers allow only a short filing deadline, sufficient data to properly bill the Third Party Carrier is imperative. We will attempt to contact the physician's office for any missing information. If unsuccessful, the client will be invoiced and responsible for the cost of services rendered.
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