United Healthcare to Continue to Contract with Local Laboratories
To: PSA Affiliated Pathology Practices and Billing Clients
Subject: UnitedHealthcare to Continue to Contract with Local Laboratories
According to a UnitedHealthcare press release, UnitedHealthcare will continue to contract with other regional and local laboratory service providers. Please review the frequently asked questions listed below for more information.
6.5.3 Phys External UHC.FAQ FinalLegalAppd 10.03.06.doc
United HealthCare National Laboratory Program Frequently Asked Questions
- What changes regarding laboratory services are UnitedHealthcare and its affiliates, including Oxford Health Plans, announcing?
Effective January 1, 2007, LabCorp will become UnitedHealthcare's sole national laboratory services provider.
Effective January 1, 2007, Quest Diagnostics will no longer be a contracted laboratory services provider for Oxford Health Plans or UnitedHealthcare except in limited markets.
UnitedHealthcare has contracted with Laboratory Corporation of America (LabCorp) for reference laboratory services. LabCorp will participate with other regional and local laboratory providers in the comprehensive and expanding UnitedHealthcare laboratory network across the United States. LabCorp will also assume responsibility for managing the Oxford Health Plans laboratory network in the greater New York metropolitan region, effective January 1, 2007.
- Who is LabCorp?
LabCorp offers laboratory services that are as complete and comprehensive as any other national laboratory company. LabCorp offers more than 4,400 types of laboratory tests from routine blood assays to HIV and genomic testing. LabCorp processes more than 360,000 specimens daily for 220,000 physicians and other clients. LabCorp is well-regarded for its complex testing capabilities related to oncology, infectious disease, and genomic, esoteric, or anatomic pathology.
In addition, LabCorp operates several affiliated Centers of Excellence including the Center of Esoteric Testing in Burlington, NC; the Center for Molecular Biology and Pathology in Research Triangle Park, NC; the Center for Occupational Testing in Research Triangle Park, NC; National Genetics Institute in Los Angeles, CA; and ViroMed in Minneapolis, MN.
LabCorp has an excellent reputation for providing outstanding customer service. An explicit goal of this new relationship between UnitedHealthcare and LabCorp, however, is to improve the diagnostic and administrative support provided to UnitedHealthcare participating physicians. As such, LabCorp is accountable to ensure that UnitedHealthcare network physicians receive a level of service commensurate with that offered by any other laboratory. UnitedHealthcare will monitor that performance based upon our own review and input from participating physicians.
Given the importance of simplifying the administrative burden of ordering and receiving diagnostic tests and results, LabCorp provides a variety of electronic interfaces that may be of interest to you. Their systems are compatible with the electronic connectivity software used by most medical practices today, and we encourage physicians to evaluate the applicability for their practice.
If physicians desire the comprehensive services and special capabilities of LabCorp, effective January 1, 2007, and are not currently a customer, they may simply contact LabCorp as follows:
To set up an account, contact LabCorp directly via e-mail at sales@LabCorp.com, or by calling 1-888-LABCORP (522-2677), Option #3.
- With LabCorp becoming UnitedHealthcare's national laboratory services provider will Quest Diagnostics still be a participating provider?
As of January 1, 2007, Quest Diagnostics will no longer be a contracted laboratory and will be considered a non-participating provider except in very limited markets.
- How will this change affect physicians?
Physicians who currently refer UnitedHealthcare patients or their lab specimens to Quest Diagnostics for laboratory services, as of January 1, 2007, must use LabCorp or another participating laboratory. For physicians who are already using LabCorp or another participating laboratory, this development will have no significant effect on their practice.
We strongly urge physicians and their practice staff to use the next few months to prepare for this transition by making any necessary arrangements with LabCorp or another participating laboratory for services to be rendered after January 1st. Physicians who rely on patient service centers to secure lab specimens should ensure those centers will be in the UnitedHealthcare network on January 1st. In anticipation of this transition, the roster of participating patient service centers will expand over the next few months.
- How will this change affect patients?
As long as physicians use one of the many UnitedHealthcare participating laboratories, there will be no effect on the patient who is a UnitedHealthcare member. However, after January 1, 2007, if patients or their specimens are referred to non-participating laboratories (including Quest Diagnostics), then UnitedHealthcare and its customers and members who are your patients will be subject to higher health care costs due to the nature of the various health care benefit plans offered and selected by purchasers and consumers. This would be an unfortunate result of inattentiveness to this issue and we desire to do all we can to prevent such consequences.
Patients are generally unaware of which laboratory service their physicians use. In 80% of cases, specimens are collected in a physician's office and picked up by a courier. Test results are then delivered electronically. In other cases, a physician may refer a patient to a patient service center to have a specimen taken. An important way a physician's office can help patients control the cost of care is to ensure that lab specimens remain in network with LabCorp or another participating lab provider. UnitedHealthcare encourages its members to take an active role in their health care and learn which laboratories participate in our network so that together we can minimize any applicable expenses associated with the use of out-of-network providers.
- Will LabCorp be UnitedHealthcare's only contracted laboratory provider?
In the overwhelming majority of the country, UnitedHealthcare's laboratory network will continue to include a combination of other regional and local laboratory service providers. In addition, in many areas we will be contracting with new providers and adding to the breadth of our network.
LabCorp will be the sole national capitated laboratory services provider for the HMO benefit plans in the markets covered by PacifiCare of Colorado, Neighborhood Health Partnership in Florida, and Mid-Atlantic Medical Services (MAMSI) in Maryland and Virginia. LabCorp is already the exclusive provider for HMO benefit plans for PacifiCare of Arizona. If you have any questions about the participating labs in your area, you can access a list of them at http://www.unitedhealthcareonline.com/ at any time.
- How can physicians obtain a list of participating laboratories?
A current list of participating laboratories is available online at http://www.unitedhealthcareonline.com/
- Will Oxford Health Plans and UnitedHealthcare have the same laboratory network?
Not necessarily. Some labs may be participating for lab services with UnitedHealthcare, but not with the Oxford Laboratory Program. A complete list of participating laboratories may be accessed as noted above.
- Are all UnitedHealthcare products included in this arrangement?
Yes. The arrangement applies to all UnitedHealthcare commercial plans, as well as acquired plans including PacifiCare, Oxford Health Plans, MAMSI, Neighborhood Health Partnership, and UnitedHealthcare of the River Valley (formerly known as John Deere Health).
- Are AmeriChoice and Ovations also included?
Yes, AmeriChoice and Ovations, including Secure Horizons products, are included.
Summary
After reviewing all the comprehensive services and special capabilities LabCorp has to offer, and given the increasingly broad array of choice among laboratories participating in the UnitedHealthcare network, we are comfortable there will be no compromise of the ability of physicians to order the diagnostic tests necessary to meet the clinical management needs of their patients. If any such issue arises, LabCorp and UnitedHealthcare are prepared to work with physicians and their practice staff to resolve the issue so that the patient covered by UnitedHealthcare can be assured access to high quality, affordable health care and a simplified experience.
For further information, contact the UnitedHealthcare Customer Service Center at 1-877-842-3210.
6.5.3 Phys External UHC.FAQ FinalLegalAppd 10.03.06.doc