Pathologists are physicians, like your regular doctor, who analyze and interpret biopsy specimens and laboratory tests. Pathologists bill separately for their services. If you don’t receive a bill for pathology services, the pathologist has received payment for professional services provided to you from government payers or by pre-arrangement from the hospital, managed care plans or your insurance company.
You may receive more than one bill for pathology services. In the case of the interpretation of biopsy specimens, you will receive one bill from the hospital for the preparation of the microscopic slides (the technical component) and one bill from the pathologists for the interpretation of those slides (the professional component).
In the case of laboratory testing on blood specimens, you will receive one bill from the hospital for instrument analysis of the specimen (the technical component) and one bill from the pathologists for the medical direction of the laboratory and its technical staff (the professional component).
Pathologists spend considerable time directing the clinical laboratory to ensure that high quality data is generated; the ultimate validity of a clinical laboratory test rests with the pathologist. The pathologist provides medical direction for the technical staff and ensures that procedures are properly being performed. New testing methodologies are evaluated and validated by the pathologist. The pathologist assures that the clinical laboratory is conforming to state licensure requirements, requirements of the Centers for Medicare & Medicaid Services, and the College of American Pathologists Laboratory Accreditation Program. The pathologist is also available to consult with your primary care provider or your specialist regarding test selection and interpretation, in order to assist your provider in finding the most beneficial approach to your medical problem. When your doctor orders clinical laboratory tests, a professional component charge for these services is added to each test.
In summary, the technical component is the hospital fee which accounts for the technical staff’s time as well as cost of instruments and reagents. The professional component is the physician’s fee for medical services provided to you in ensuring that your test results are timely and accurate.
The pathologist also assesses a professional component charge for a variety of other services as well. For example, the pathologist’s interpretation of a cytology specimen, or body fluid, or peripheral smear will also result in a professional charge.
The pathologist’s charges do not duplicate any charges in the hospital’s bill. The hospital is not authorized to bill for the pathologist’s professional services. Any hospital payment received from your insurer other than Medicare Part A does not contain any amount for the pathologist’s professional services.
Depending on which tests your physician ordered, your bill might either be from Pathology Associates of Central Illinois (PACI), Clinical Pathologists of Central Illinois (CPCI), or both. Please call the numbers below for additional information or questions:
Clinical Pathologists of Central Illinois, Ltd. 217-522-7004
Pathology Associates of Central Illinois, Ltd. 800-535-3072