About

What is a pathologist?

A pathologist is a medical doctor who helps identify disease by examining tissue, cells, blood, and other specimens. Pathologists combine these findings with medical information to provide diagnoses that help guide your care.

Much of this work takes place behind the scenes. Your pathologist works with your treating physician and laboratory team to provide information needed for treatment decisions.

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What are the main areas of pathology?

Pathology has two primary branches:

-Anatomic pathology focuses on examining tissue and cells, such as samples collected during a biopsy or surgery, to identify disease.

-Clinical pathology focuses on laboratory testing of blood, urine, and other body fluids. It also includes medical oversight of laboratory testing to help ensure accurate, reliable, and useful results.

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How can I understand my pathology report?

Your pathology report describes the findings from the examination of your specimen. It may include medical terminology, a diagnosis, and results from additional testing.

Your treating physician can explain how these findings relate to your health and discuss any recommended next steps.

For additional guidance, visit the College of American Pathologists’ patient resource: How to Read Your Pathology Report.

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Why did I receive a bill from Pathology Associates, P.A.?

Pathology Associates, P.A. provides physician services that support your diagnosis and care. These services may include examining a biopsy or surgical specimen, interpreting diagnostic findings, or providing professional clinical laboratory services.

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Our bill represents the pathologist’s professional services. The hospital or facility may issue a separate bill for specimen preparation, laboratory equipment, supplies, and other technical services.

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If you have health insurance, your claim is submitted using the insurance information available to our office. Any patient balance depends on how your plan processes the claim, applicable billing requirements, and your coverage.

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Why am I receiving a bill if I never met the pathologist?

A face-to-face visit is usually not needed for pathology services. Your physician sends a specimen to the laboratory, where the pathologist performs the necessary examination or provides professional laboratory services.

Although you may not meet your pathologist, their work contributes to the information your medical team uses to care for you.

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What is the professional component of clinical pathology?

Clinical laboratory testing involves both technical work and physician services.

The technical portion includes performing the test using laboratory personnel, equipment, and supplies. The professional portion includes the pathologist’s medical direction, oversight, and consultation that support dependable testing and clinically useful results.

These professional responsibilities can include:

• Establishing and reviewing testing methods and laboratory procedures.

• Overseeing quality control and investigating testing problems.

• Guiding laboratory staff when results are unusual or unexpected.

• Consulting with treating physicians about test selection and findings.

• Helping establish procedures for reviewing and reporting results.

• Supporting compliance with laboratory licensing, certification, and accreditation requirements.

These services support patient care even when an individual test result does not require a separate, personal review by a pathologist.

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What does “modifier 26” mean on a claim?

Modifier 26 is a billing designation used to identify the professional portion of a service when it is reported separately from the technical portion. For pathology claims, it distinguishes the physician’s professional services from the laboratory or facility services. Its use and payment depend on the procedure, insurance plan, and applicable billing rules.

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What should I do if my insurance denies a pathology charge?

A denial means your insurance plan has declined payment for a claim or service. It does not, by itself, determine whether you owe the charge. Insurance plans may apply different coverage and reimbursement policies to pathology services. A denial may require clarification, correction, or an appeal.

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If your Explanation of Benefits mentions a no covered service, modifier 26, or another issue you do not understand, please contact our billing office. We can review the claim, explain the status of your account, and discuss any appropriate next steps.

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Who should I contact about my bill?

For questions about a statement, insurance processing, or your account, please call 

Pathology Associates, P.A. at 727-328-7800.  Please have your statement or account number available when you call. To protect your privacy, please do not send medical records, insurance identification numbers, or other sensitive information through ordinary email.