Clinical Pathology Associates | Frequently Asked Questions
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Frequently Asked Questions

The Billing Department for Clinical Pathology Associates is located at 3445 Executive Center Drive, Suite 250, Austin, TX 78731. We can be reached by telephone by calling (512)579-4000 or toll free at (877)608-8643. Our team of billing specialists is available to serve you Monday-Friday, 8AM-5PM CST.

Most physician offices, hospitals and surgery centers send insurance information with the laboratory specimen, but occasionally we will need additional information. After the insurance has been filed and payment has been received and posted, we will bill you the balance due. You will generally not receive a bill until insurance has responded with a payment or denial. 

 

When calling about your account, please have your insurance card and any other pertinent information on hand. We accept Visa, MasterCard, Flexible Spending Cards, and Health Savings Accounts online as well as by telephone.

 

If you have questions about your individual laboratory coverage benefits and how it is determined, please contact your insurance plan provider or benefits specialist. Our trained billing staff is always willing to help in any way they can but will not have access to specific details about your personal plan.

 

Please see our FAQ section below for more detailed answers to frequently asked questions.

Clinical Pathology Associates

What phone number can I call if I have questions about a statement or letter that I have received?

The customer service department can be reached at (512)579-4000. Our hours of operation are from 8am until 5pm Monday through Friday.

What is the mailing address for Clinical Pathology Associates?

Clinical Pathology Associates

P.O. Box 28770

Austin, TX 78755

Can I send an email to customer service?

Yes, emails can be sent to customer.service@clinicalpathologyassoc.com and will be answered by a billing specialist. Please allow 24-48 hours for a response.

How can I pay my bill?

Payments are accepted via mail, online and over the phone.

 

In order to pay your bill online you will need a current statement from CPA. The statement will have underneath the credit card box on the top third of the page the information necessary to allow you to pay your balance. If you have received a letter and not a statement you will need to call (512)579-4000 to pay your bill over the phone.

Why have I received a bill?

Our bills are for laboratory services either performed by our pathologist or under the supervision of our pathologist at various hospitals, surgery centers, and physician offices in Central Texas.

Will Clinical Pathology Associates send a claim to my insurance company?

Most referring providers include your insurance information when your records are sent to us from the facility where you received treatment. At times, the insurance information can be incorrect or missing. We send a statement approximately 2 weeks after we receive your lab work for insurance verification. Should your insurance information be incorrect or missing, please contact our office to provide the correct information.

Will my insurance pay for my laboratory tests?

You will need to call your insurance company to verify that your policy covers the laboratory tests.

I paid a copay at my hospital/surgery center/physician's office. Why am I getting a bill from Clinical Pathology Associates?

We are a separate provider from your physician office and as such must bill separately from the facility where you received treatment. Your insurance company will send a separate explanation of benefits (EOB) for our work. Patient responsibility from your EOB will be billed to you.

How do I request copies of my medical records?

Please refer to the information in the link below.

Patient Records

How do I request copies of my billing records?

Please refer to the information in the link below.

Patient Records

Where can I find information regarding your privacy practices?

Please see our Notice of Privacy Practices.

Understanding Your Explanation of Benefits (EOB)

An Explanation of Benefits (EOB) is the documentation your insurance company sends to explain how your claim was processed. The insurance payment is sent to Clinical Pathology Associates and a copy of the EOB is sent to you, in order for you to determine how much you may owe. Please remember that the Explanation of Benefits (EOB) that you receive from your insurance company is not a bill. If Clinical Pathology Associates determines that your insurance processed your claim incorrectly, we will appeal that claim to your insurance company.

Charge Amount

This is the amount charged by Clinical Pathology Associates for each test performed.

Allowed Amount

This is the amount your insurance company allows for each test before deductibles and coinsurance. Each insurance company determines their allowable rates for each participating provider.

Deductible

This is the amount that must be paid by the patient before insurance will begin reimbursing for covered services. Deductibles generally must be met each year. They are accumulated for all medical services combined.

Coinsurance

This is the portion of allowed charges that is the responsibility of the patient. Many insurance companies may require a 10%-30% coinsurance after deductibles.

 

Copayment

A standard set amount that is due for a particular service for each visit. Sometimes co-insurance is also applied to lab charges even if a copayment has been applied.  Varies by insurance plan and insurance company.

Amount Paid

This is the amount paid by the insurance company after all adjustments, coinsurance and deductibles have been taken out.

Contract Adjustment or Excess of UCR (Usual, Customary and Reasonable)

This is the portion of the charge that is greater than the amount allowed by the insurance company. If Clinical Pathology Associates is under contract with the insurance company, this amount is not the patient’s responsibility. If there is no contract between our lab and the insurance company, this amount is owed by the patient. “UCR” stands for usual, customary and reasonable. Each insurance company sets its own UCR. This does not mean that this test has been overcharged.

Non-Covered

This is a charge that is excluded from your contract and is non-payable by your insurance company. Some reasons could be that the procedure is considered investigational by your particular insurance company, a non-covered diagnosis was provided by the physician office or the test has been performed too frequently for the diagnosis given. In some cases a test may not be covered by your particular plan, especially in the case of ‘Well Woman” coverage. You may be responsible for these charges and this amount will show in the patient responsibility column. The patient responsibility column is the amount you may owe Clinical Pathology Associates. This amount includes coinsurance, deductible and non-covered service amounts.