UnitedHealthcare will require providers to document members’ written consent and obtain UnitedHealthcare approval prior to referring members to an out-of-network laboratory.
According to the UnitedHealthcare bulletin1, ”out-of-network laboratory referrals can create excess costs in the health care system and may pose a potential quality risk to your patients”.
To avoid these, UnitedHealthcare will implement the following required process, effective November 8, 2019, if you refer to an out-of-network laboratory:
Per the UnitedHealthcare bulletin1, “Care providers who refer a laboratory service to an out-of-network care provider and haven’t completed the referral request process and documented the member’s written consent are out of compliance with their Participation Agreement and may be subject to administrative actions, which include:
To learn more, visit the UnitedHealthcare Requirements for Out-of-Network Laboratory Referral Requests bulletin.