This article is intended for physicians, clinicians, and other providers who order clinical laboratory services for our members
Please remember when referring our members for medically necessary clinical laboratory services, you should make your best efforts to use providers who participate in our networks.
We've noticed an increase in claims submitted by non-participating laboratories such as AccuReference Medical Lab. AccuReference is not a contracted clinical laboratory.
Why we request that you use a participating laboratory
Using a participating laboratory helps reduce health care costs in general and for your patients specifically.
- Non-contracted laboratories may charge substantially more than in-network (contracted) laboratories, leading to increased health care costs overall.
- Members may be subject to balance billing and, depending on their plan, could also be responsible for additional costs. These out-of-pocket costs often confuse members when they receive their explanations of benefits (Summary of Health Plan Payments).
- Contracted laboratories must meet rigorous credentialing standards, including accreditation from either the College of American Pathologists or a Clinical Laboratory Improvement Amendment (CLIA) certificate.
- Many of our contracted clinical laboratories have the ability to easily share patient results with your practice, such as integrating with your electronic medical record systems.
Steps you can take
- Please review your office workflows to make sure you’re always referring to a contracted clinical laboratory as a first option.
- You can find a participating clinical laboratory by using Find a Doctor & Estimate Costs. Enter "Clinical Lab" in the search window and choose the member’s network, then select Enter.
Questions?
If you have any questions, please call Network Management and Credentialing Services at 1-800-316-BLUE (2583). As always, thank you for the care you provide to your patients—our members—and for your efforts to refer in our networks.
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