Participating Provider Laboratory & Pathology Protocol
June 28, 2016UnitedHealthcare requires physicians and other qualified health care professionals to inform patients who are our members when referring them to or including a non-network provider in that patient’s health plan. Beginning Sept. 1, 2016, UnitedHealthcare network physicians and other qualified health care professionals in Delaware, Massachusetts, New Hampshire, New York, Oklahoma, Pennsylvania, and Texas are required to obtain consent from UnitedHealthcare members before referring them to or using non-network laboratories and pathologists for their care. This includes: specimens collected in-office and sent to a non network laboratory or pathologist for processing; AND providing a member with a prescription, requisition or other form to obtain laboratory or pathology services outside your office. Prior to any referral to, or the inclusion of, a non-network laboratory or pathologist in a UnitedHealthcare member’s care, the physician must: Discuss network and non-network care provider options with them and provide them with a copy of UnitedHealthcare’s Laboratory and Pathology Services Consent Form. This form is separate from the Member Advance Notice Form for Involvement of a Non-participating Provider. After the discussion, the member must complete the Laboratory and Pathology Services Consent Form indicating whether they wish to use a network or non-network laboratory or pathologist.