Connecting People to Information/Patients
We are glad to help.
Most people meet us only through a bill or a result, so here is who we are: after your procedure, the laboratory at your hospital or clinic prepared your specimen, one of our pathologists examined it, and the diagnosis went back to the doctor caring for you.
Talk to a person
817.293.4304
Call us and somebody in our office will pick up. No portal, no queue — if we cannot answer your question ourselves, we will find the person who can.
Phone hours
Monday
8:00 am – 5:00 pm
Tuesday
8:00 am – 5:00 pm
Wednesday
8:00 am – 5:00 pm
Thursday
8:00 am – 5:00 pm
Friday
Closed
Paying a bill
Pay online, or call and we will walk you through it.
Keep your statement nearby — the account number printed on it is the only thing the payment page asks for. If the bill is confusing, or the timing is difficult, please call us before it worries you. We would far rather talk it through.
Pay online →
Why you heard from us
A doctor you never met, and that is quite normal.
Pathologists work behind the scenes. We are the physicians who look at the tissue, the fluid or the blood and say what it is — which is how your own doctor knows what to treat and how to treat it. We work inside the hospitals and clinics where you are cared for, alongside the laboratory teams there.
Your results
Go to the physician who ordered them. They are the right person to explain what the diagnosis means for you.
Your specimen
Is prepared by the laboratory at the hospital or clinic where you were seen — and where one of our pathologists is laboratory medical director — and then examined and diagnosed by one of our physicians.
Your bill
Covers the physician work of examining and diagnosing your specimen. It is separate from the hospital or clinic bill.
Your protections · the No Surprises Act
You should never be surprised by a pathology bill.
Federal law protects you when you receive emergency care, or when you are treated at an in-network hospital or surgical center by a provider who happens to be out-of-network. Pathology is one of the services that protection was written for.
Emergency care
If you have an emergency and are treated by an out-of-network provider or facility, the most you can be billed is your plan’s in-network cost-sharing — your usual copayment and coinsurance. That holds for care you receive after you are stable, too.
In-network hospitals and surgical centers
Some providers working inside an in-network facility may be out-of-network. For pathology, anesthesia, radiology, laboratory and similar services, they may bill you no more than your in-network share, and cannot ask you to waive that.
What balance billing means
An out-of-network provider bills you the difference between what your plan paid and what they charged. Where these protections apply, that difference is simply not yours to pay.
When you might still get a bill
You are never required to give up these protections, and you are never required to be treated out-of-network. You may always choose a provider or facility in your plan's network.
Where balance billing is not allowed, you owe only your usual share — the copayment, coinsurance or deductible you would pay for an in-network provider — and your health plan pays us directly. What you pay counts toward your deductible and out-of-pocket limit.
+Read the full notice
Help with an insurance claim · RAP coverage
If your plan treated us as out-of-network, it is worth one phone call.
RAP stands for radiology, anesthesiology and pathology — three specialties you almost never get to choose for yourself. Because of that, many insurance policies include a RAP provision: these services are covered at your regular in-network benefit level even when the individual physician is not in your plan's network.
Insurers do not always apply that provision on their own. Often it takes a call from you, asking them to check the policy and reprocess the claim. Here is what to have in front of you, and what to ask.
If a bill still looks wrong
Call us first on 817.293.4304 — most of these turn out to be something we can fix. You may also contact the CMS No Surprises Help Desk at 1.800.985.3059, or the Texas Department of Insurance at 1.800.252.3439.
When you might still get a bill
You are never required to give up these protections, and you are never required to be treated out-of-network. You may always choose a provider or facility in your plan's network.
Where balance billing is not allowed, you owe only your usual share — the copayment, coinsurance or deductible you would pay for an in-network provider — and your health plan pays us directly. What you pay counts toward your deductible and out-of-pocket limit.
−Hide the full notice
Out-of-network
Describes providers and facilities that have not signed a contract with your health plan. Outside the protections above, they may bill you the difference between what your plan agreed to pay and the full amount charged, which is usually more than the in-network cost for the same service and may not count toward your annual out-of-pocket limit.
Surprise billing
An unexpected balance bill. It happens when you cannot control who takes part in your care — during an emergency, or when you book a visit at an in-network facility and are treated by an out-of-network provider. You may still be billed for services your plan does not cover at all.
What your plan must do
Cover emergency services without prior authorization; cover emergency services from out-of-network providers; base what you owe on what it would pay an in-network provider and show that figure in your explanation of benefits; and count what you pay toward your deductible and out-of-pocket limit.
Help with an insurance claim · RAP coverage
If your plan treated us as out-of-network, it is worth one phone call.
RAP stands for radiology, anesthesiology and pathology — three specialties you almost never get to choose for yourself. Because of that, many insurance policies include a RAP provision: these services are covered at your regular in-network benefit level even when the individual physician is not in your plan's network.
Insurers do not always apply that provision on their own. Often it takes a call from you, asking them to check the policy and reprocess the claim. Here is what to have in front of you, and what to ask.
1
Before you call
Call the Member Services number on the back of your insurance card, and have these in front of you:
—Your insurance card
—The patient’s name and date of birth
—The date of service — it is on your bill, or on the letter from us
—The claim number, if you have one
—A pen and paper, for names and reference numbers
2
What to ask
You do not need a script. These honest questions will get you the answers:
“I’m calling about a claim from Texas Pathology for services on [date]. Can you tell me its status and how it was processed?”
“Does my policy include a RAP provision — coverage for radiology, anesthesiology and pathology services?”
“If it does, was this claim processed under it? If not, can you reprocess it at my in-network benefit level?”
“Do you need anything from me to do that, and is there a deadline?”
“When will the reprocessing be complete, and will I get a new explanation of benefits?”
“Can I have a reference number for this call, and your first name?”
If they tell you your policy has no RAP provision, ask whether there is any hold or flag on the policy, or anything they still need from you, that is keeping the claim from processing. Answer their questions honestly — and if you are not sure about something, it is perfectly fine to say so.
3
After the call
Send a short email or letter to your insurer summarising what was discussed and anything the representative committed to, including the reference number and their first name. Keep a copy for your records — a written record helps if the insurer does not follow through. Reprocessing usually takes 30 to 45 days; if no updated explanation of benefits has arrived by then, call back with the reference number from your first call.
4
If they say no
You have the right to file a formal appeal. Call our billing office and we will go through the options with you.
817.293.4304
11838 Medpark Drive, Suite 103
Burleson, TX 76028
817.293.4304 · contact@texpath.com
Burleson, TX 76028
817.293.4304 · contact@texpath.com
Connecting People to Information.
A member of the Independent Pathology Practice Network
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