Billing Policies & Guidelines

Your physician has chosen Promus Diagnostics (“Promus”) for your laboratory testing needs. Promus is dedicated to delivering the highest quality laboratory services and to providing you with simple and clear answers to your billing questions. We appreciate your physician’s confidence in our laboratory and look forward to serving your testing needs.

Because medical billing can be complex and confusing, we have created the following FAQs to help patients understand their financial responsibilities related to our lab testing services. To discuss a bill or any aspect of our billing services contact a billing specialist at 817-778-9210 Ext 121.

I received an Explanation of Benefits (“EOB”) from my insurance company. What does this mean?

An EOB is a document sent by your insurance company to let you know that it has processed a claim for healthcare services on your behalf or for a covered family member. THE EOB IS NOT AN INVOICE OR BILL and is simply an explanation of charges. After the physician ordered a test, Promus performed the test, sent the results to the physician, and submitted a claim to the insurance company. The EOB shows the following:

  1. A breakdown of the covered amount by the insurance company
  2. Potential patient co-pays and deductibles

The Medicare program typically requires Promus to accept whatever amount Medicare pays (known as the Medicare allowable fee) as payment in full. If you are a Medicare beneficiary, you may be responsible for a 20% coinsurance payment as indicated by the Medicare Professional fee schedule. The majority of patient’s have either supplemental insurance (also known as “GAP” coverage) or other secondary insurance, which will likely cover the entire coinsurance amount. If this is true in your case, you will not be responsible for any payment. A Medicare part B deductible also may apply, in which case you will have to pay the deductible amount.

You are only responsible for the amount that you owe based on your health insurance plan and its determination of the allowed payment amount. For example, the total billed to an insurer is $1,000.00, the in-network allowed amount determined by the insurer is $600.00, $525.00 of which was covered and paid by the insurance. In this example, the patient pay amount is $75.00. ($50.00 for remaining deductible + $25.00 for coinsurance). You DO NOT PAY the un-allowed balance amount of $400.00.

Please contact our Billing Department at 817-778-9210 Ext 121 and one of our billing specialists will be happy to help.

Certain insurance companies may pay your claim by sending a check directly to you as the insured. This check is the insurance company’s payment for laboratory testing performed by Promus. Promus will bill you for the amount paid to you by the insurance company. If you receive a check, paid to you on our behalf, from your insurance company, please immediately do the following:

  1. Endorse the check by signing it on the back and, write “Pay To: Promus” under your signature
  2. Mail this check to: Promus Diagnostics; 2300 Dean Way, Suite 130, SOUTHLAKE, TEXAS 76092
  3. Please include a copy of your Explanation of Benefits (EOB) that originally came with your check. This will ensure that this check is applied to the proper account.

Promus offers a very reasonable, discounted patient price for uninsured patients to ensure that all patients can have access to these important diagnostic tests.

Yes. If a patient can demonstrate financial hardship, he or she may qualify for a discount on, or waiver of patient payment responsibilities. You can learn more about our Financial Assistance Policy by contacting our Billing Department. To do so, please call 817-778-9210 Ext 121.

Allowable Rates

Promus accepts the allowable rate of a carrier regardless of contract status.  If the charge is $100 and the carrier allows $25 – then Promus writes off the $75 difference.  When you hear the phrase ‘balance billing’ it refers to charging the patient the difference between what the lab charges and what the carrier allows – a practice Promus does not do. 

If the $25.00, which the carrier allows, is applied to the patient’s copayment or deductible, the patient will be billed for that copayment or deductible. To be compliant, Promus follows the same billing policy regardless of network status.

Co-payments and Deductibles

If there is a remaining balance of the allowable charges which is the patient’s responsibility, the patient will receive three (3) statements for the allowed remaining balance indicated by the insurance company. After 120 days, the allowed balance of the patient’s bill will be considered for adjustments in most cases. 

A patient will receive three (3) statements for the allowed remaining balance indicated by their insurance carrier if the following occurs:

  • A portion of the claim is applied to their deductible.
  • They have a co-payment portion designated by their insurance carrier.
  • They do not have insurance coverage.
  • The insurance carrier pays the patient directly. 

Payment Plan Options

In the event you need to pay your balance over time, Promus has engaged a third party finance company that will set up a payment plan for you. There is no interest charged on unpaid balances.

Uninsured Patients

Patients without insurance coverage will be charged at a discounted rate of $250.

Prompt Payment Policy

Promus has a prompt payment discount where any patient responsibility will be discounted if the payment is made within 30 days.

Hardship Policy

Promus has a hardship policy which includes a discount of up to 100% of any patient responsibility where the patient can demonstrate a genuine financial hardship and need. To apply for a financial hardship discount, please call 817-778-9210 Ext. 121 and request a copy of our hardship form. In addition to the information on the form, you will need to submit your most recent pay stub (if any), your last year’s IRS tax return and the number of dependents in your household.

We’re committed to providing the highest level of service to our patients, healthcare providers, and business clients. If you have questions, concerns, or comments, please contact us at info@promusdiagnostics.com.