IMMUNOSCIENCES LAB., INC. (Contact Us)

Payment and Billing Policies

Dear Practitioners:

The following are the payment policies for Immunosciences Lab., Inc. We invite practitioners to use our 50% Panel Price discounts when ordering selected panels as indicated in the Catalog of Services 2004. PCR tests are excluded from price discounts.

Payment Methods:

Submit payment in full (check, money order, cashier’s check, or credit card information) with the blood sample. ISL will provide a complete receipt to patients for their insurance reimbursement.
Practitioners may open an account with ISL for testing services (please see page 8 for account information). Practitioner accounts will be billed monthly;
Give authorization to use an on-file credit card (practitioner account holder only); All accounts are subject to Immunosciences Lab., Inc. credit review and approval. Credit limits may be established for practitioner accounts.

Important Insurance/Medicare Information:

Insurance billing is no longer available to patients as of October 1, 2003. Also, as of March 1,2004, ISL ceased being a Medicare provider. Patients are financially responsible for services provided by ISL and full payment must be included with specimen(s).

ISL will submit to patients a detailed receipt of services for their insurance reimbursement.

Immunosciences Lab., Inc. is not a preferred provider for any health care providers.

Practitioner Information:

Practitioners who would like to set up an account with Immunosciences Lab., Inc. must return a signed copy of the form on the following page. Accounts are subject to approval. All lab fee accounts are payable upon receipt of a monthly statement. Prior arrangements must be made with Immunosciences Lab., Inc. to establish credit and set up an account. Special testing panels may be custom designed and prices will be determined mutually between Immunosciences Lab., Inc. and the ordering physician. Customized panels require a minimum of

10 patient samples and 5 tests per patient.

General Information:

All prices listed are in U.S. Dollars and are subject to change without notice.

Balances over 30 days are subject to a 10% service charge. Immunosciences Lab., Inc. does not accept Medi-Cal/Medicaid from any state in the U.S.

Immunosciences Lab., Inc. is licensed to conduct selected tests only. Please contact Immunosciences Lab., Inc. to obtain a list of tests available and approved by the State of New York.

PROFESSIONAL COURTESY

Immunosciences Lab. Inc., cannot honor requests for professional

courtesy testing since California State Law prohibits

offering such service.

FEE CHANGES

Due to advances in scientific methodologies, some components

of our tests may be updated. These changes may

cause an increase in our fees. Methodologies and fees are

subject to change without prior notification.

REFERRAL TO ANOTHER LABORATORY

Immunosciences Lab. Inc,. will charge 20% as a processing

fee for all tests referred to another laboratory.

CPT CODES

CPT codes provided in our directory are for guidance in billing.

These codes reflect our interpretation of CPT coding

requirements only, and are subject to change at any time.

QUALITY ASSURANCE

Comprehensive quality assurance is in place for every single

test performed in order to monitor the sample from specimen

pick-up to reporting results. Participation in the independent

quality assurance programs such as the College of American

Pathologists (CAP), documents our superior performance for

accuracy and precision during daily laboratory testing.

• All prices are in U.S. Dollars and are subject to change without

prior notice.

Test results are for physician use only.