As previously communicated, beginning October 1, 2017, AmeriHealth HMO, Inc. and AmeriHealth Insurance Company of New Jersey (collectively, AmeriHealth New Jersey) will begin a phased approach to make Laboratory Corporation of America? Holdings (LabCorp) the exclusive nationally based provider of outpatient laboratory services for AmeriHealth New Jersey 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.
Why we made this decision
Health care has been undergoing rapid, remarkable change, spurred by implementation of the health care reform law, an increasing focus on the individual consumer, and continuing cost pressures. In late 2016, AmeriHealth New Jersey initiated a project to evaluate an exclusive national outpatient laboratory network concept, which has been effective in helping other insurers contain medical costs without affecting quality. Our relationship with LabCorp, a leading national laboratory, will allow for enhanced clinical initiatives to improve patient care without reducing access to participating outpatient labs.
Laboratory providers in the AmeriHealth New Jersey network
In light of this transition, AmeriHealth New Jersey will be ending its contracts with the following laboratories as outlined below:
- Quest Diagnostics™ (Quest). Effective October 1, 2017, the contract ends for AmeriHealth New Jersey health plans, and Quest will be an out-of-network provider.
- BioReference Laboratories (BioReference). Effective March 1, 2018, the contract ends for AmeriHealth New Jersey health plans, and BioReference will be an out-of-network provider.
- Health Network Laboratories® (Health Network). Effective May 1, 2018, the contract ends for AmeriHealth New Jersey health plans, and Health Network will be an out-of-network provider.
These laboratories will remain as in-network outpatient laboratory providers with AmeriHealth New Jersey until their contracts end.
In-network specialty laboratories
LabCorp includes the following subsidiaries of its specialty testing group: Dianon Pathology, Integrated Genetics, Integrated Oncology, Litholink, Medtox Laboratories, and Monogram BioSciences.
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 prior to October 1, 2017
If your practice is currently capitated to either Quest, BioReference, or Health Network for outpatient laboratory services, your practice will need to select another in-network capitated outpatient laboratory provider once the contract ends.
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 October 1, 2017.
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 like LabCorp 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 prior to October 1, 2017.
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.
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.