If a specimen is sent to an outside laboratory from the physician's office, who is responsible for payment if the physician bills for the service on the insurance claim?

In situations where a specimen is sent to an outside laboratory, the physician's office remains responsible for the billing process, including payment responsibilities related to the laboratory services. When the physician bills for the service on an insurance claim, it indicates that they are providing a comprehensive service, which includes the work associated with the laboratory analysis.

The physician's office typically has contractual agreements with insurance companies that dictate how services, including those performed by third-party labs, are billed and paid. Hence, when the physician submits a claim for the service, they are effectively billing for the entire episode of care that includes any laboratory work, even if that work is performed outside their practice.

In this scenario, while the insurance company may ultimately pay for the covered services according to the patient's policy, the office of the physician assumes the responsibility to ensure that the claim is settled appropriately. Therefore, the correct answer regarding who is responsible for payment when the physician bills for the service is indeed the physician.