10. What should pathologists do about the central state's decision?

The appeals court in Central states was concerned that the admission forms provided to the patients upon admission to the hospital did not fully explain the nature of the pathologist's professional component of clinical pathology services or that patients would receive bills for these services. Consequently, pathologists should review the admission and outpatient registration materials presented to patients at the hospitals and other facilities at which they practice. They should discuss modifications or supplements to these materials in order to address the decision of the Florida appeals court.

Most pathologists have not thoroughly written explanations of the nature and charges of professional components of clinical pathology services. They should include informative materials to all patients with regards to the professional bill. These materials should clearly explain that the patient may receive bills for professional components of clinical pathology services and state that the patient is financially responsible for those services. The pathologist may wish to include these materials, with a signature line for the patient to confirm that they have read and understand the billing policies of the services. This information may be made part of the hospital admission/registration forms. The following is an example of a much shorter description which can be used:

"while you are in the hospital, you may receive atomic or clinical laboratory tests directly performed by a pathologist. You may also receive clinical laboratory tests that will be performed under the supervision and direction of the pathologists but are not personally performed by the pathologist. Although a pathologist may not perform these tests or personally review the results, the pathologist is responsible and legally obligated for the supervision and direction of the laboratory. You may receive a bill for these services. By signing this form, you agree to pay the pathologists charges for these current services if your health plan does not cover all of the pathologist's charges."

The above listed documentation should be added to the contract between hospitals and pathologists that would obligate the hospitals to include this type of language on the hospital admission forms. The hospital should also state that compensation received by the pathologists from the hospital for professional components of clinical pathology services is for specific patient categories and the pathologists have the right to Bill and collect for professional components of clinical pathology services for all other patient categories.

The hospital's contract should prohibit their own negotiation with payers to receive compensation for any professional service provided by pathologist. Pathologists should also periodically review their own pair contracts carefully to ensure that the contracts do not prohibit the pathologist from billing for professional components of the clinical pathology services.