Lab Contract Participation
UnitedHealthcare Laboratory Services Information
Network Reference Lab can bill directly to clients -- including physician or clinic -- or to a patient/third party or private insurance. Network Reference Lab accepts assignment for Medicare and Medicaid.
Client -- Physician -- Clinic
Clients are billed monthly with an itemized invoice that includes the date of service, patient ID number and name, test performed and the fee for each specimen processed during that month. Please remit payment upon receipt of the bill.
Patient -- Third Party -- Private Insurance Billing
If the client doesn't want to be billed directly, Network Reference Lab bills the patient or third party. Co-payments and deductibles are billed as appropriate. Most insurance payments are made on a negotiated fee schedule and the fee is payment in full. In some cases, a percentage of the fees is paid by insurance, and the balance is the patient's responsibility.
Medicare Part B Billing
Network Reference Lab bills Medicare for Medicare Part B patient testing, in accordance with legal and regulatory requirements.
Medicaid is state medical assistance for those who cannot afford their own health-care insurance. You can only file for Medicaid after all other third-party resources have been exhausted. Network Reference Lab bills Medicaid for testing performed for Medicaid patients.
Network Reference Lab is able to file claims on a patient's behalf with several insurance companies and managed care organizations.
This information must be included on the requisition:
- Patient's complete name, gender and date of birth
- Patient's complete address and phone number
- Social security number
- Primary care physician and ordering physician
- Billing party
- Copy of insurance card
- Medicare, Medicaid numbers or insurance group and ID number
- Insured name
- Secondary insurance plan information
- Diagnosis for each ordered test
The client must provide Network Reference Lab with all necessary medical, demographic and billing information, including the diagnosis for each ordered test and specific encounter, and any other necessary information to accomplish billing.
If Network Reference Lab is unable to obtain payment from any third party, Medicare, Medicaid, or is required to return or repay amounts previously paid due to inadequate documentation or exclusive sole source arrangements, the client will be billed.
If the client's failure to provide required information or failure to direct the specimen to the correct laboratory as a result of the client's failure to follow rules or regulations, Network Reference Lab will bill the client.
It is the responsibility of the client to reimburse the laboratory for the amount.