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AML Billing Department Information

Billing Corrections - Forms & Instructions

Please clearly print your corrections on the Billing Correction Form (interactive)

To remove charges from your account and send to patient's insurance, please provide the following:

• Patient's full name
• Date of service
• Accession Number
• Patient address
• Insurance group and policy numbers for both primary and secondary policies
• Diagnosis (ICD-9 code is preferred)

Requests for billing changes MUST BE SUBMITTED within 60 days of invoice receipt. Daily billing logs are available to allow timely review of all charges applied to your account. Please alert your account representative if you would like a daily billing summary sent to your office.View Billing Correction Form(pdf)

Adjustment Instructions Example


Fax Completed Form To: 612-262-5965
Questions Call: 612-262-4000

Here is the Billing Correction Form in a PDF format that can be printed and faxed to the above number.



CPT/Client Fee Request Instructions (4/07 pdf)
Client CPT Fee Request Form (pdf)
Client CPT Fee Request Form ( Interactive)


Client Provider Change Form (pdf)

Client Provider Change Form (Interactive)

ABN Test List (4/08 pdf)
 

Allina Medical Laboratories
800 E. 28th Street, Minneapolis, MN 55407
612-863-4678
1-800-281-4379
E-mail us