As previously communicated, AmeriHealth HMO, Inc. and AmeriHealth Insurance Company of New Jersey (collectively, AmeriHealth New Jersey) began a phased approach to make Laboratory Corporation of America® Holdings (LabCorp) the exclusive nationally based provider of outpatient laboratory services for AmeriHealth New Jersey effective May 1, 2018. As of May 1, 2018, the AmeriHealth New Jersey network will also include other currently contracted specialty laboratories that will remain in our network in addition to LabCorp.
Note: This change will affect your patients who carry AmeriHealth New Jersey or AmeriHealth Administrators ID cards.
Laboratory providers in the AmeriHealth New Jersey network
As a reminder, we ended our contract with Quest DiagnosticsTM as of October 1, 2017, and with BioReference Laboratories as of March 1, 2018, and these providers are now out-of-network.
As the transition continues, AmeriHealth New Jersey will be ending its contract with Health Network Laboratories® (Health Network) effective May 1, 2018, at which time Health Network will become an out-of-network provider.
Health Network will remain as an in-network outpatient laboratory provider with AmeriHealth New Jersey until their contract ends.
Re-issue of ID cards for affected members
If your practice was capitated to BioReference for outpatient laboratory services, and we did not receive a request to select a different in-network capitated outpatient laboratory provider, AmeriHealth New Jersey automatically assigned LabCorp as your capitated outpatient laboratory provider as of March 1, 2018.
As a result of this new assignment, HMO and POS members were issued a new member ID card that indicates the member?s capitated laboratory provider through the Lab Indicator.
As they do today, physicians should check the member?s ID card and use the Eligibility and Benefits Inquiry transaction on the NaviNet® web portal to verify the capitated laboratory provider for HMO and POS members. Using NaviNet ensures that practices have the most accurate information.
In-network specialty laboratories
LabCorp includes the following subsidiaries of its specialty testing group: Accupath Diagnostic Laboratories, Inc., Dianon Pathology, Integrated Genetics, Integrated Oncology, Litholink, Medtox Laboratories, Monogram BioSciences, and Sequenom Center for Molecular Medicine, LLC.
In addition to LabCorp, the AmeriHealth New Jersey network will also continue to include other currently contracted specialty laboratories. The complete list can be found here.
For primary care physicians
Updating your capitated outpatient laboratory provider
Those practices that are capitated to Health Network for outpatient laboratory services will need to select another in-network capitated outpatient laboratory provider before May 1, 2018.
Please note that if we have not received a request to (1) remain with your current in-network capitated outpatient laboratory until their contract ends or (2) select a different in-network capitated outpatient laboratory provider, AmeriHealth New Jersey will automatically assign LabCorp as your capitated outpatient laboratory provider effective May 1, 2018, for those providers capitated to Health Network.
To select a capitated outpatient laboratory provider other than LabCorp, please contact your Provider Partnership Associate to make changes.
Use an in-network outpatient laboratory provider
As a primary care physician, you are reminded to direct HMO and POS members to your capitated outpatient laboratory provider. In addition, EPO and PPO members should be referred to an in-network outpatient laboratory to save on member out-of-pocket costs.
Complete the Lab Connectivity Survey
In preparation for this transition, provider offices will need to establish their electronic interfaces with LabCorp so they can order, view, share, manage, and analyze lab results. If your office needs to establish electronic interfaces with LabCorp, please complete the Lab Connectivity Survey.
You can complete the survey electronically and either email it to NEITServiceDesk@labcorp.com or fax it to 1-855-400-2426. We strongly suggest completing the survey as soon as possible to establish your electronic interfaces.
About LabCorp's connectivity options
LabCorp offers a variety of test ordering and result delivery solutions that provide the flexibility to meet clients' needs, including several electronic options:
- Web-based or Windows®-based electronic solutions: Go to www.labcorp.com/beacon for more information.
- Bi-directional and uni-directional interfaces: LabCorp has established interface capabilities with more than 600 EMR (electronic medical record) and PMS (practice management software) systems.
Available resource
We have created a flyer to help members understand the following:
- The changes to AmeriHealth New Jersey?s outpatient laboratory provider network;
- Cost differences between using an in-network or an out-of-network lab;
- How to find an in-network laboratory.
If you have patients who may benefit from this information, you may request copies of the flyer to include in their charts.To order a supply of flyers for your office, please submit an
online request.
For more information
For additional information, including a frequently asked questions document, visit the Exclusive National Outpatient Lab Provider section of our Provider News Center. This page will be updated as new information becomes available. For more information about LabCorp, please visit their website.
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