1. How the process works and road blocks that we face.
Billing Department
How the process works and road blocks that we face.

2. Flawless Billing Flow
Any Client Bill requisitions are invoiced to the client for payment.
Each requisition is scanned and reviewed by the Charge Entry team to verify details
and enter
insurance and diagnosis code.
Money received from client/insurance/patient is posted within Comtron and Advanced MD.
Files are created and transferred into Advanced MD.
Correct accessions are transferred to the patients insurance via the clearing house.
Any patient statements are created and sent to the patient for payment.

3. Real Billing Flow Client/patient Issues Missing Information
Any Client Bill and patient invoices are created.
Money is
received from client, insurance and/or patient and is posted within Comtron and Advanced MD.
Each requisition is scanned and reviewed by the Charge Entry team to verify details and enter insurance and diagnosis code.
Client/patient
Issues
Files are created and transferred into Advanced MD.
Missing Information
Once fixed or addressed….
Correct/Corrected accessions are transferred to the patients insurance via the clearing house.
Non payment after 30 days
Clearing house rejects claim
Correct the issue the insurance has advised and once fixed…

4. insurance and diagnosis code.
Client Bill
Each requisition is scanned and reviewed by the Charge Entry team to verify details and enter
insurance and diagnosis code.
Any Client Bill requisitions are invoiced to the client for payment and uploaded into HC1.
Money received from client/insurance/patient is posted within Comtron and Advanced MD.
Client sending client bill specimens without contract on file.
Requisition does not have billing information marked.
Client marks requisition incorrectly and needs to be adjusted off of invoice to bill patients insurance.
Client disputes contract and never pays Castle.

5. Is the client billing for the specimen or should Castle?

6. Missing Information Road Blocks
Each requisition is scanned and reviewed by the Charge Entry team to verify details and enter
insurance and diagnosis code.
Files are created and transferred into Advanced MD.
Money received from client/insurance/patient is posted within Comtron and Advanced MD.
Corrected accessions are transferred to the patients insurance via the clearing house.
Road Blocks
Any requisition that does not reflect the following must be obtained from the client before it can be billed.
billing information marked
insurance details
diagnosis code
patient address
patient DOB
Once fixed or addressed….

7. What is missing? Ordering Physician Billing information marked
Patients sex
Specimen Source
Diagnosis Code
Test Requested
Provider Signature with Date

8. Unbilled Error Road Blocks
Each requisition is scanned and reviewed by the Charge Entry team to verify details and enter
insurance and diagnosis code.
Files are created and transferred into Advanced MD.
Correct accessions are transferred to the patients insurance via the clearing house.
Money received from client/insurance/patient is posted within Comtron and Advanced MD.
Road Blocks
If the clearing house rejects a claim, they are sent back to Castle to review and correct. Some unbilled errors are:
Patients insurance is not active for date sample was collected.
DOB is missing or invalid to what may be on file with insurance.
Subscriber name missing/invalid on requisition.
Name doesn’t match insurance card.
The requisition should reflect the referring provider who is registered with a NPI number.
Once fixed or addressed….

9. Account/Receivable Road Blocks
Each requisition is scanned and reviewed by the Charge Entry team to verify details and enter
insurance and diagnosis code.
Files are created and transferred into Advanced MD.
Correct/Corrected accessions are transferred to the patients insurance via the clearing house.
Money received from client/insurance/patient is posted within Comtron and Advanced MD.
Road Blocks
Correct the issue the insurance has advised if possible and once fixed…
After 30 days and the payment has not been received at Castle,
the insurance is contacted to verify status. Some issues are:
Payment was sent to patient.
Patient does not have out of network benefits.
No authorization was obtained prior to service.
Referring provider is not registered with an updated NPI number.

10. Road Blocks Client Bill Missing Information Unbilled Errors
Client sending client bill specimens without contract on file.
Requisition does not have billing information marked.
Client marks requisition incorrectly and needs to be adjusted off of invoice to bill patients insurance.
Client disputes contract and never pays Castle.
Missing Information
Any requisition that does not reflect the following much be obtained from the client before it can be billed.
billing information marked
insurance details
diagnosis code
patient address
patient DOB
Unbilled Errors
If the clearing house rejects a claim, they are sent back to Castle to review and correct. Some unbilled errors are:
Patients insurance is not active for date sample was collected.
DOB is missing or invalid to what may be on file with insurance.
Subscriber name missing/invalid on requisition.
Name doesn’t match insurance card.
The requisition should reflect the referring provider who is registered with a NPI number.
Accounts Receivable
After 30 days and the payment has not being received at Castle, the insurance is contacted to verify status. Some issues are:
Payment was sent to patient
Patient does not have out of network benefits
No authorization was obtained prior to service
Referring provider is not registered with an NPI number.

11. Patient receives EOB and/or Castle Medical statement and has questions.
Billing Office: 855-CASTLE0
Methods that a patient or client pay their bill.
Patients can pay online at and select Pay My Bill.
Patient and/or the client can call to make payment over the phone.
Billing Office: 855-CASTLE0 and ask for Susan or Lucy.
Client has questions regarding their client bill invoices/account.
Contact their assigned Client Bill Representative: (See map by state)
Gina Stieber:
Lucy Perkins:
Susan Mayberry:
Client has received requests regarding missing information.
Contact the Missing Information team.
Whitney Pind:
Jacqui Shockley:
Toye Wilson:

12. Help Us