Frequently Asked Questions

General
What is a pathologist?
How does your physician work with pathologists?
How does ECP bill for pathology services?
I never had to pay for a Pap; my insurance always covered it in the past. Why are you billing me now?

Women's Health
What is a Pap test?
Why get a Pap test?
What is HPV?
What is Chlamydia and Gonorrhea?
What is Herpes Simplex Virus (HSV)?

General

What is a Pathologist?
Pathology is the study of disease. Pathologists are specially trained medical doctors who have completed medical residency (and often times further specialized training) in pathology. They dedicate most of their time to interpreting microscopic information from the body that might indicate the presence of diseases. Pathologists use microscopes to look at slides prepared from biopsies or other collections of cells, such as those that come from Pap tests. Many pathologists focus on general surgical pathology (examining specimens removed during major and minor surgeries) and some receive additional subspecialty training in a variety of areas, such as cytopathology, dermatopathology, hematopathology, etc. Pathologists also often own, oversee, maintain, and/or direct laboratories where tissues and cellular specimens are processed using technologically advanced equipment and highly trained laboratory personnel.
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How does your physician work with pathologists?
Pathologists are often called the "physician's physician" by their colleagues in other medical specialties, a tribute to the importance of the pathologist in patient care. Your physician speaks with a pathologist regarding critical health information including diagnosis of disease, indications of disease prognosis, additional testing that may be conducted, and potential therapeutic interventions. Pathologists are your physician's partners in patient care. This means that you have another doctor that you may never meet face-to-face. In short, pathologists often provide the information your physician needs to make a determination of how to care for you. For more information please visit the following websites: http://en.wikipedia.org/wiki/Pathology or College of American Pathologists. Each web site provides helpful information about the medical specialty of pathology.
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How does ECP bill for pathology services?
Most pathology services are covered under most insurance plans. Your physician will typically provide ECP with your medical insurance information along with your specimen. ECP will bill your insurance directly for the pathology services performed. If your insurance company denies the claim or any portion of it (for example, if you have a deductible that must be met, or if the test that your physician orders is not covered by your particular plan), you may then receive a bill from ECP for anything that your plan does not cover. If you do not understand why you are receiving a bill from ECP, the first step you can take is to contact our billing departnment.
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I never had to pay for a Pap; my insurance always covered it in the past. Why are you billing me now?
Typically Paps are covered in full by insurance plans as an integral part of routine medical exams. In the past, you may have Pap tests that if they were normal, they were probably fully paid by your insurance plan and you had no further responsibility. However, if suddenly the Pap diagnosis is abnormal (e.g. ASCUS, LSIL, HSIL or CIN, etc.) it becomes what we term "diagnostic" and thus ceases to be "routine". It is then treated by most insurance plans just like any other diagnostic test (a biopsy for example) and you may have to pay a portion of the bill depending on your specific benefits and the level of your deductible.
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Women's Health

What is a Pap test?
While studying ovarian and uterine cycles in vaginal specimens in 1923, George N. Papanicolaou, MD discovered that the cells of women with cervical cancer showed abnormal changes. In 1943, he and gynecologist Herbert F. Traut published Diagnosis of Uterine Cancer by the Vaginal Smear. Further research demonstrated that pre-cancerous changes could also be detected. This research and subsequent screening practices led to the most successful cancer-screening tool in history: the Pap test, named after Dr. Papanicolaou. Modern Pap tests are performed on new new liquid-based technologies, with SurePath™ and ThinPrep® being the dominant ones.
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Why get a Pap test?
The Pap test has been the single most effective screening tool ever available to modern medicine in the fight against cancer. If caught early and treated properly, cervical cancer is curable. The American Cancer Society states that cervical cancer deaths have dropped by 74% since 1955 in the U.S., and the death rate from cervical cancer continues to decline at a rate of 4% per year. These favorable numbers are attributed to the use of the Pap test. Cervical cancer is, generally speaking, very slow to develop. Changes in the cells of the cervix can be detected by microscopically examining them after they are collected by your doctor and sent to a pathology laboratory. If abnormalities are found early, treatments are extremely effective.
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What is HPV?
It has been established that almost all cervical cancers are caused by the human papilloma virus, or HPV. There are over 100 strains of this virus, and only a few of these cause cervical cancer. It is an extremely common virus, and anyone who has been sexually active is at risk. HPV can live in the body for many years without showing any signs of infection. Therefore, even those people who for years have been with only one partner or not sexually active at all may still have the virus. Many pathology laboratories can screen for this virus using the same cellular material collected by your Pap test. You and your physician should determine whether you would like to have an HPV test as a primary screening (regardless of the results of your Pap test), or as a reflexive screening (only if your Pap test shows that the cells in your cervix indicate that the virus may be present). HPV can be present even if your Pap test does not show any abnormal cells, so you should explore all your options with your doctor.
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What is Chlamydia and Gonorrhea?
These are two other common, sexually-transmitted organisms (in addition to HPV) that can be detected from the cells collected during your Pap test. They are both treatable and rarely life-threatening (except in infants who can contract it in the birth canal), but they are nevertheless potentially dangerous, uncomfortable (even painful), and at the least, tremendously inconvenient. Chlamydia (Chlamydia trachomatis), can cause a number of infections. In women, common manifestations include cervivitis, salpingtis, and acute urethral syndrome. Men infected with Chlamydia may develop conditions including epididymitis, urethritis, and proctitis. Perhaps most disturbing about Chlamydia is the potential effects on newborn infants, who may contract, among other things, conjunctivitis and pneumonia. Gonorrhea (Neisseria gonorrhea) often does not produce symptoms in women, though it can lead to suppurative salpingitis, ovaritis, ovarian abscess, and peritonitis. In men, gonorrhea most frequently causes urethritis with significant pain and pus-discharge. Your doctor will determine when to screen you for Chlamydia and Gonorrhea, typically together, and usually only if you have a symptom of one of the infections or if you think you may have been exposed to them from an infected sexual partner.
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What is Herpes Simplex Virus (HSV)?
Herpes is another common organism infection a large percentage of the population. Genital herpes (herpes can also be oral, such as the common cold sore) infects approximately one in four adults in the U.S. There are two types, HSV-1 and HSV-2. HSV 2 is the type most commonly found in genital herpes (though either type can be found both orally and genitally). Herpes infection is usually mild and not dangerous, though it can cause life-threatening situations if passed from an infected mother to a newborn. The symptoms range from mild (sometimes undetectable) to severe (painful, rash-like lesions). Significant dangers to adults do exist from HSV infection: it can increase susceptibility to HIV (the virus that causes AIDS), and for women infected with HPV (the virus that causes cervical cancer (see HPV section), it can increase the risks of developing cervical cancer. If you suspect you may have herpes, discuss your options with your doctor.
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