Explanation of Benefits

Submitting Your Insurance Claim through Physicians Lab

Before your appointment with your physician, you will receive your urine testing kit in the mail from Physicians Lab. In that kit, you will find a questionnaire and a payment/insurance information form.

These forms will need to be filled out to completion and returned to Physicians Lab, if you would like a claim submitted to your insurance for your laboratory testing. If you prefer, you may complete the forms online at PhysiciansLab.com (you must have registered an account with Physicians Lab and be logged in to complete these forms. To register with Physicians Lab now, www.portal.physicianslab.com.

How You will be Billed for Lab Testing through Physicians Lab

The remaining maximum balance bill due after the insurance payment has been received by Physicians Lab will be charged to your credit card on file.

In some cases with out-of-network providers, insurance companies (Aetna, Blue Cross Blue Shield of South Carolina and others) will send payments to its members for service provided by out-of-network providers. Generally, these payments are sent to the patient because the patient has been charged up front the entire balance of the services.  However, because Physicians Lab protects you with the Sure Pay program, the lab does not charge you upfront and, if you receive payment from your insurance company, the entire payment is due back to the lab.

Payment toward deductibles, co-pays or other insurance nonpayment categories do not count toward your balance. An email stating the balance owed and amount to be charged to your credit card will be sent to you 24 hours prior to charge of the payment. If you have questions about these charges, you have 24 hours from receipt of this email to contact Physicians Lab. To ensure receipt of this email, please add Billing@physicianslab.com to your contact.

Maximum Patient Responsibility

Each insurance plan incorporates a maximum patient responsibility, which varies by insurance provider. Maximum patient responsibility is the maximum out-of-pocket expense you will be charged after the Prompt Pay Discount has been applied. A Prompt Pay Discount is a regulatory rule that allows out-of-network providers to limit the out-of-pocket expense incurred. This discount may be provided to you if your balance is paid on an expedited timeline. If you receive payment direct to you from the insurance company, as noted above, your payment is not susceptible to the Prompt Pay Discount rule.

Maximum patient responsibility can be reduced if payment is received directly from the insurance company.

Explanation of Benefits (EOB)

Following submission of your insurance claim by Physicians Lab, you will receive an email from your insurance company, titled, “Explanation of Benefits,” or EOB. An insurance Explanation of Benefits is an itemized invoice of charges billed to your insurance company for the laboratory services provided to you. An EOB is NOT a bill but simply an itemization of the benefits provided to you.

Contact Us

If you have additional questions about insurance billing with Physicians Lab, please contact customer service at (800) 525-4052 or Billing@physicianslab.com