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Semper Fi Labs Billing Policy

PATIENT BILLING

Semper Fi Labs performs specialized urine and oral fluid drug toxicology testing for medication monitoring and drugs of abuse. Once performed the results are reported directly to the ordering provider within 24 to 48 hours. At that time, Semper Fi Labs will submit the claim to the patient’s respective insurance carrier (Payer).

The factors that affect a payer’s decision to reimburse these specialized tests include the patient’s diagnosis, the payer’s policy or specific coverage determination to reimburse such tests.
After your insurance provider has determined coverage, you will receive a statement as patient responsibility for the amount determined by your carrier as patient liability.

For patients that are self-pay, uninsured, or have a financial hardship, you will receive a patient statement within 1-2 weeks following your laboratory testing.

INSURED PATIENTS WILL BE BILLED DEDUCTIBLES, CO-INSURANCE AND CO-PAYMENT AMOUNT AS REQUIRED BY LAW AND REQUIRED BY THEIR INSURANCE PROVIDER

Office of Inspector General (OIG) and Insurance providers require laboratories like Semper Fi Labs to bill patients for deductibles, co-insurance and co-payment amounts as reflected on the explanation of benefits (EOB) for testing for each date of service as to avoid any policy violation or any violation to STARK/Anti-Kickback law. The amount of your payment liability is determined by your insurance carrier. Semper Fi Labs accepts all forms of commercial insurance and will bill on your behalf.

Testing and charges performed for Workers’ Compensation are billed directly to the Workers’ Compensation Plans at our standard rates. There is typically no patient responsibility for this type of testing.

FINANCIAL ASSISTANCE PROGRAM

Central Tox is committed to a compassionate and friendly billing policy by working with patients to make the billing process as stress-free as possible. You will receive a statement when there is financial responsibility for the testing ordered by your provider. We encourage you to contact our billing department (number located on your statement) to discuss financial assistance options. Several payment options are available to those who qualify:

  • Prompt Pay Discount – Central Tox may offer a prompt pay discount for balances paid in full within 30 days of the initial statement.
  • Uninsured Discount – for an individual who does not have health insurance, or is not eligible for health care coverage for services provided by the lab.
  • Payment Plans – payment plans may be established for outstanding balances and will be determined on an individual basis.

The factors that affect a payer’s decision to reimburse these specialized tests include the patient’s diagnosis, the payer’s policy or specific coverage determination to reimburse such tests.
After your insurance provider has determined coverage, you will receive a statement as patient responsibility for the amount determined by your carrier as patient liability.

For patients that are self-pay, uninsured, or have a financial hardship, you will receive a patient statement within 1-2 weeks following your laboratory testing.

INSURED PATIENTS WILL BE BILLED DEDUCTIBLES, CO-INSURANCE AND CO-PAYMENT AMOUNT AS REQUIRED BY LAW AND REQUIRED BY THEIR INSURANCE PROVIDER

Office of Inspector General (OIG) and Insurance providers require laboratories like Central Tox to bill patients for deductibles, co-insurance and co-payment amounts as reflected on the explanation of benefits (EOB) for testing for each date of service as to avoid any policy violation or any violation to STARK/Anti-Kickback law. The amount of your payment liability is determined by your insurance carrier. Central Tox accepts all forms of commercial insurance and will bill on your behalf.

Testing and charges performed for Workers’ Compensation are billed directly to the Workers’ Compensation Plans at our standard rates. There is typically no patient responsibility for this type of testing.

INSURANCE PAYMENTS MADE DIRECTLY TO PATIENTS

Some insurers may send the insurance payment directly to the patient instead of Central Tox. In the event that you receive payment for our laboratory services, please forward this payment directly to Central Tox and write on the back of the check “Pay to Central Tox.,” include a signature and a copy of EOB if possible and mail to:

Central Tox
Attn: Billing – Insurance Reimbursement
525 Round Rock West Dr #B240
Round Rock, TX 78681

In the event a patient does not forward the insurance payment to Central Tox, the laboratory may send these patients to an outside collection agency.