Office of Managed Care Operations

VI. LABORATORY SERVICES

HMO REQUIREMENTS FOR OUT PATIENT LAB PROCEDURES

MANAGED CARE ORGANIZATION

LAB SERVICES CAN BE DONE AT UMDNJ

(IF YES- SCRIPT IS ALWAYS NEEDED)

 REFER PATIENT TO AUTHORIZED FACILITY

(SCRIPT IS ALWAYS NEEDED)

PRE ADMISSION TESTING CAN BE DONE

AETNA US HEALTHCARE

NO

LABCORP OR QUEST

YES

AMERIGROUP

NO

LABCORP

YES

AMERICHOICE 

YES

 

 

YES

AMERIHEALTH INS of NJ 

 

TO BE DETERMINED MUST CALL INSURANCE CARRIER                Location for Lab Services is decided by the PCP

 

YES

EMPIRE HEALTH CHOICE (formerly NY BCBS)

 NO

QUEST DIAGNOSTICS

YES

HORIZON BLUE CROSS & BLUE SHIELD

HMO, POS, MEDICARE BLUE  (NO0

TRADITIONAL & PPO  (YES0

LABCORP

YES

HORIZON MERCY

NO

LABCORP

YES

 

HEALTHNET                    (formerly PHS)

NO

QUEST

YES

GREAT WEST HEALTH CARE (formerly One Health Plan) PLAN of NJ

YES                                        No Referral Required

 

YES

QUALCARE

NO

LABCORP

YES

UNIVERSITY HEALTH PLAN

YES                                           No Referral Required

 

YES

WELLCHOICE

NO

QUEST
DIAGNOSTICS

YES

 

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