What is pathology?
“Pathology is a branch of medical science primarily concerning the cause, origin and nature of disease. It involves the examination of tissues, organs, bodily fluids and autopsies in order to study and diagnose disease.” You can learn more about pathology and/or your diagnosis on the Cancer.gov site.
Who are Western and Pinnacle Pathology?
Western Pathology Associates, Ltd and Pinnacle Pathology, PC comprise an Arizona based anatomic pathology medical practice and laboratory. The companies service Honor Health hospitals and various ambulatory surgical centers, endoscopy centers, radiology practices and physician offices. Our pathologists also provide clinical laboratory and medical direction (Medical Directorship) for the following Arizona-based Honor Health hospitals: Deer Valley Medical Center, JCL Medical Center and Sonoran Health Emergency Center.
Why choose Western and Pinnacle Pathology?
Our team of board certified pathologists have over 60 years of combined experience. We provide fast and accurate diagnosistics incorporating all essential ancillary information necessary to guide treatment. We take pride in our rapid turn-around time, with reports typically issued within 24 hours of specimen receipt.
With Western & Pinnacle Pathology, you and your physician have dedicated advocates for your patient care.
Why have I received a bill from Western and/or Pinnacle Pathology?
You recently had a procedure at an Honor Health hospital or outpatient facility or possibly you had clinical lab work done at an Honor Health hospital. Maybe your physician performed a procedure at their medical practice. If any of these scenarios sound familiar, you should know that Western and Pinnacle Pathology perform laboratory diagnostic services to include the anatomic laboratory testing, physician diagnosis of anatomic laboratory testing, and/or Medical Directorship oversight of clinical laboratory testing at certain Honor Health facilities.
Bills from Pinnacle Pathology generally include outpatient laboratory testing and professional services (diagnosis) from procedures performed at your referring physician’s facility. These are billed as a global services component. Bills from Pinnacle Pathology also may only include the laboratory testing portion of anatomic pathology specimens received from Honor Health hospital procedures. These are billed as a technical services component.
Bills from Western Pathology generally include professional services/diagnosis of the laboratory testing of anatomic pathology specimens received from Honor Health hospital procedures. Bills from Western Pathology may also include Medical Directorship oversight services of the clinical laboratory to assure reliable laboratory results and quality of care. These are billed as a professional services component.
What tests will be performed and how much will they cost?
It is difficult to determine the exact number of specimens resulting from your procedure or the precise testing necessary for diagnosis, and therefore, cost. The laboratory may receive multiple biopsies and/or other specimens from a single procedure. The pathologist may see the need for special stains or additional testing to be performed in order to be able to render a definitive diagnosis.
Does Western & Pinnacle Pathology accept my insurance?
We make best efforts to ensure in-network processing of all our claims; however, there are many different plans and plan specific provisions within any given insurance company. If we are not a participating provider with your insurance or your specific plan prohibits in-network processing, you are responsible for any out-of-network deductible and/or co-insurance. Patients should also read the Federal No Surprises Act Disclosure for government legislation that may apply to your type of service.
We will file all primary and secondary insurance claims on your behalf based on the information sent to us when the testing is ordered. Once all plans have processed your claim, you will be billed for any remaining portion. If you have updated or additional insurance information, please contact our billing office.
Please remember, only you can be certain your insurance company processed your claim according to your plan provisions. If you feel your claim was processed incorrectly, please contact your insurance company and/or our billing office.
Why isn’t this covered at no additional cost under my co-pay or laboratory testing services?
Co-payments typically cover physician office visits only. Insurance plans have varying benefit levels for pathology laboratory testing. Any patient responsibility is based on your member agreement with your health plan. This will be reflective on your billing statement from us as well as your explanation of benefits (EOB) from your insurance. Please remember, only you can be certain your insurance company processed your claim according to your plan provisions. If you feel your claim was processed incorrectly, please contact your insurance company and/or our billing office.
The explanation of benefits that I received from my insurance is different from Western and/or Pinnacle Pathology’s billing statement. Why?
Your explanation of benefits (EOB) from your insurance is not our bill. If we believe your insurance processed your claim incorrectly, we will appeal to your insurance on your behalf and may, where eligible, provide additional discounts. Payments should be made in accordance with our billing statement.
Are there programs for uninsured, underinsured, and/or patients experiencing financial hardship?
We are a community-based organization working with others to build a community where financial assistance is available for our most vulnerable members. We are committed to making every effort to assist patients to meet their financial obligations.
As such, we have several programs to assist our patients with their financial obligations to include a self-pay discount, Payment Plan agreement, and Financial Assistance Program for those experiencing financial hardship. Please contact our billing office if you are interested in learning more about any of these programs.
Ask your referring physician’s facility about our Self-Pay Agreement at the time of your services, and/or contact our billing office for other program information. Note, once a claim has been filed with your insurance, we cannot accept a Self-Pay Agreement for services rendered.
What are my payment options?
Western & Pinnacle Pathology accepts checks, money orders, VISA, Master Card, Discover, American Express and Paypal. PLEASE DO NOT SEND CASH AS RECEIPT CANNOT BE GUARANTEED. You may pay your bill online, by mail or phone. For more information, please see our Contact and Payment page.
How can I obtain a copy of my test report?