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Forms & Tools

To simplify your laboratory operations we are making available several the following sample forms and tools that can be adopted in your organization. New topics will be added in response to the healthcare industry implementation of new policies and procedures.

Advance Beneficiary Notice for PAP Smears

Advanced Beneficiary Notice (EXPIRED)

Client Cut Off Letter 1

Client Final Collection Letter 1

Client Info Request Letter 1

Client Info Request Letter 2

Client Letter 1

Client Letter 2

Client Letter 3

Client Letter 4

Client Letter 5

Client Letter 6

Client Payment Agreement 1

Client Settlement 1

Client Settlement 2

Client Welcome Letter

Collection Service Agreement

Deposit Log Spread Sheet

Dx Do's and Don't

Dx Request Letter

Frequency Denial Appeal

Indigent Patient Agreement

Pap Tanner

Physician Acknowledgment

Policy for Diagnosis

Policy for Obtaining Third Party Billing Information

Policy for Standing Orders

Promissory Note

Revised Advance Beneficiary Notice (Effective 09/2008)

Revised Advance Beneficiary Notice Instructions

Sample Over-Payment Refund Letter

Travel Allowance Calculation Guidelines