Billing & Payment

QDx Pathology Services is an anatomical pathology laboratory that performs tests at the request of a licensed provider or other persons authorized by law to order laboratory testing and receive testing results. In many cases, when a provider performs a procedure such as a colonoscopy, prostate biopsy, bladder biopsy, etc. they remove a tissue sample from the patient. A pathologist (provider specializing in tissue diagnosis) is sent these samples by your provider. Under microscopic examination, the pathologist analyzes your tissue sample, and the pathologist bills your insurance company directly for their services. Therefore, if you receive a bill from QDx Pathology, it is because QDx was asked to diagnose your tissue samples by your provider.

The toll-free telephone number for Patient Billing is 866-909-7284.

A Billing Representative is available Monday thru Friday 8:00 AM to 4:30 PM.

QDx Pathology Services will file claims directly to Medicare, Medicaid, and many/all insurance companies and managed care plans.

Before you have lab tests performed, please make sure:

• For third-party billing, a copy of both sides of the insurance card or the following information must be provided:
  • Patient’s full name as it appears on the card
  • Patient’s full address
  • Patient’s gender and date of birth
  • Patient’s current area code and telephone number
  • Insured name (if different from patient)
  • Referring physician’s name
  • All appropriate ICD-10 diagnostic codes
  • Insurance company’s complete name and address
  • Insured policy number / Insurance ID Number
  • Insured Group Number

  Note: Patients are responsible for yearly deductibles and any balances not covered by their insurance company.

• For Medicare Billing: If you are covered by Medicare, please supply the following information:
  • Patient’s full name as it appears on the card
  • Patient’s current address
  • Patient’s gender and date of birth
  • Patient’s current area code and telephone number
  • Referring physician’s name
  • Referring physician’s 5-digit UPIN number with alpha prefix written on the test requisition form
  • All appropriate diagnostic codes
  • Medicare HIC number

Please contact your provider to receive an explanation of the tests ordered and results received.

In most cases, if you received a bill from QDx Pathology, you owe co-pay, deductible or other additional payment as required by your insurance company.

You may have also received a bill from QDx Pathology because QDx was either given incorrect insurance information or no insurance information. In this case, you may have received a bill for the full amount of QDx Pathology’s services, if you provide us with complete and accurate insurance information; QDx Pathology will then submit a bill to your insurance carrier on your behalf.

Please ensure that you always give your provider all the information from your insurance card prior to any procedure or visit, this will help alleviate any delays in processing your claims accurately and in a timely manner.

If QDx Pathology billed your insurance provider initially but did not receive a timely response from the insurance company, QDx Pathology will bill you directly. Please contact QDx Pathology’s billing department in this event and ensure that we have the correct insurance billing information. If we did not initially have the correct information, we will re-submit the claim with the revised information.

If you have any further questions or concerns about the bill, please feel free to contact our billing department at (866) 909-7284 and one of our Billing Specialists will be happy to answer any of your questions.

The reasonable and customary fee for a service is determined by your insurance company and represents the prevailing fee for services in a given geographical area. This is the amount that the insurance carrier believes is appropriate payment in full for the service rendered.

QDx Pathology Services will send you a statement approximately once a month until the balance due for services we performed has been paid on full.

QDx Pathology Services reserves the right to refuse service if you have a past due balance. However, if you have any questions, or would like to speak to a Billing Representative to discuss your outstanding balance please call QDx Pathology Services Patient Billing at 866-909-7284 to discuss how we may assist you in this matter.

Charges denied because QDX Pathology Services is not in-network with your insurance will be billed ONLY if your insurance provider has indicated that it is the patient’s responsibility for any/all outstanding charges. Patients not responsible for outstanding charges will be adjusted as an out- of-network adjustment in accordance with your insurance carrier.

If you receive a bill from QDx Pathology Services, you may make a payment using one of the following methods:

• Money orders, personal checks, and all major credit cards are acceptable forms of payment. Please remember to attach the stub from your bill when mailing in your payment. If paying by check, please include your account number on the check.
• Toll-free telephone number: Call the Billing Department at 866-909-7284, from 8:00 am – 4:30 pm, Monday to Friday and a Billing Representative will be happy to assist in taking your payment
• Mail: Send your payment in the return envelope provided with your statement
• To pay online go to: https://billpay.myadsc.com/qdx which is conveniently located on your billing statement

If you do not have insurance or your health care benefits do not cover laboratory testing services, you will have to pay for the tests performed by QDx Pathology Services. QDx offers a self-pay rate of 70% of the Medicare allowable to patients who do not have Health Insurance. Payment plans are available, our Patient Billing Representatives are trained to assist patients with their payment questions and are available Monday through Friday at 866-909-7284.

QDx Pathology Services offers programs to support those patients who have financial needs, such as:

• Patient-specific payment plans
• Hardship considerations/adjustments

Please call QDx Pathology Service’s Patient Billing Specialist at 866-909-7284 for more information about these options/alternatives.

Once your insurer has processed your claim, you will receive an Explanation of Benefits (EOB) from your insurer informing you of the amount it will pay for your laboratory services.

The EOB is not a bill, but it may indicate that a balance remains which is your responsibility. That balance may include your copayment, deductible, or other costs outlined in your terms of coverage. The EOB is not a bill; it is an estimate of your financial responsibility for the individual claim. Your insurer will inform QDx Pathology Services regarding any balance you may owe, and QDx will then send you a bill in accordance with your insurance carrier’s instructions.

Please read your bill carefully. A line-item adjustment will be printed on the first bill you receive from QDx Pathology Services if we have received payment from your insurance company. If you are still uncertain, you can either contact your insurance company directly or contact QDx Pathology Services Patient Billing at 866-909-7284 and a Billing Representative will be happy to assist you.

If you are covered by more than one commercial insurance plan, your primary insurer will process your claim first, and then any remaining balance will be billed to the secondary insurer. If you receive a bill from QDx Pathology Services before you receive an Explanation of Benefits from your secondary insurance, please contact Patient Billing at 866-909-7284 to confirm your secondary insurance information was received and a claim was filed.

You should have received an Explanation of Benefits from your insurance company that explains, in detail, the services as either paid or denied. If you need further assistance determining the reason(s) why your insurance company did not pay for your services, please contact your insurance carrier directly for information about its coverage policies.

QDx Pathology Services relies on the ordering physician to submit the diagnosis code information at the time of the test order.  Please contact your provider's office if your insurance company denied a claim due to the diagnosis code or medical necessity.

Please allow your insurance company, a minimum, 4 to 6 weeks to process your claim.

If you have received an Explanation of Benefits from your insurance company that shows different information than the bill you received from QDx Pathology Services, please forward a copy of your Explanation of Benefits to QDx Pathology Services or contact Patient Billing at 866-909-7284 and a Billing Representative will be happy to assist you.

You may fax this information to 732-621-8341 or mail a copy of the EOB to:

QDx Pathology Services, inc.
300 Columbus Circle, Edison,
New Jersey 08837
ATTN: Billing Department

Your credit/HSA card information is safe with us. QDx Pathology Services secures this data and protects it within our network. We have adopted payment card industry security standards, and we will destroy your card information after a charge has been processed or your insurance company has notified us that you are not responsible for any charges.

Please forward the check, along with the EOB you received to:

QDx Pathology Services
300 Columbus Circle
Suite A
Edison, NJ 08837
ATTN: Billing Department

This will allow QDx to properly credit your account so that you will only receive a statement for the remaining patient responsibility amount.