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| Patient Billing Information | Healthcare Provider Billing Information | Pay My Bill | Contact Billing | FAQ's | Update My Insurance/Address |
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CompuNet will bill the physician, the patient, or selected third parties, according to your preference indicated on the test request form. Please ensure that all information is complete to avoid being billed for the tests.
- Check the “Third Party” box in the top center of the requisition.
- Patient’s Date of Birth and Sex is required.
- Indicate the person completing the requisition.
- Indicate relationship to the Insured.
- Complete the billing information on the right side.
Patient Name, Address, City, State, Zip and Phone
- ICD-9 Diagnosis Code required for reimbursement.
- Record the Patient’s Third Party Member Number
and Group Number in the Insurance section of the requisition.
- A complete claims address is required
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