Requirements for Out-of-Network Laboratory Referral Requests
AI Summary
UnitedHealthcare now requires providers to complete an online exception process and obtain written member consent before referring commercial benefit plan members to out-of-network laboratories. Providers must use the UnitedHealthcare Provider Portal to upload member consent forms and receive approval for each out-of-network lab referral.
Action Required
Immediately: All providers must complete online exception process via UnitedHealthcare Provider Portal before referring commercial members to out-of-network laboratories. Obtain written member consent for each referral and upload consent forms through the Eligibility and Benefits tool. Contact Provider Services number on member ID card to find in-network labs before ordering tests. Failure to follow this process may result in financial responsibility for member costs, loss of Practice Rewards eligibility, decreased fee schedules, and potential network termination.
Plan Types
Commercial
Specialties
all-specialties