Professional Component of Clinical Pathology

If you have an questions regarding the professional component of clinical pathology billing or your invoice from Professional Analytics, please call 833.554.2443.

 

1. What is it?

Professional component of clinical pathology billing (PCCP), is where the pathologist bills for his/her services for oversight of a hospital pathology laboratory. This is a common practice amongst pathology groups. Due to the work involved in setup (reports needed from hospital), some hospital administration groups will choose to increase medical directorship fees to offset the billing of this service.

 

2. Who is Professional Analytics?

Professional Analytics is a wholly owned subsidiary of Incyte Pathology and utilized for the sole purpose of billing out the professional component of clinical pathology. Professional Analytics was developed several years ago.

 

3. When did we begin?

Incyte began billing the professional component again recently. The go live date of this was 05/01/22, with a retro date for charges going back 3 months.

 

4. Do we plan on expanding this service?

Yes, we are currently reviewing all hospital contracts to see where we may expand services.

 

5. Who do we bill for the services?

We bill insurance and patients for these services. If it is a non-allowable charge, we do not send any statements to the patient. Patients are billed for any deductibles and / or co-pays.

 

6. Who bills this out?

Change Healthcare (now owned by Optum) bills all charges out on behalf of Professional Analytics.

 

7. How does Change Healthcare know what to bill?

There is an extract file set up that is transferred directly from the hospital to Change Healthcare (our billing vendor for PCCP) daily that shows all charges. There is a translation table set up to convert hospital order codes to CPT codes.

 

8. How do patients know that they are getting a bill?

This is up to the hospital to communicate with the patients. There is a great example of what hospitals can give to their patients from CAP (link below).
PC Billing Information Package (cap.org)

 

9. Are we getting paid for these services?

Yes, we are currently being paid. While not all payers accept the guidelines put out by CMS and CAP, there are many that do still recognize and pay for these services.

10. Is there verbiage on the statements?

Yes- the verbiage that is printed on every statement is below.

11. Where can I learn more about professional component of clinical pathology (PCCP)?

www.captodayonline.com/Archives/feature_stories/component_billing.html