UnitedHealthcare Announces Changes to Preauthorization Process for Genetic & Molecular Lab Tests
Effective November 1, 2017, UnitedHealthcare will require ordering care providers to request online notification/prior authorization for genetic and molecular lab tests for members who carry UnitedHealthcare Commercial benefit plans.
Certain tests will require ordering care providers to request notification/prior authorization through this process before lab tests can be reimbursed:
• Tier 1 Molecular Pathology Procedures
• Tier 2 Molecular Pathology Procedures
• Genomic Sequencing Procedures
• Multianalyte Assays with Algorithmic Analyses that include Molecular Pathology Testing
Ordering care providers will need to sign in to UnitedHealthcare’s Link portal and complete the online notification/prior authorization process for tests included in the Genetic and Molecular Lab Test requirement.
If your request meets UnitedHealthcare’s clinical and coverage guidelines, you will get a decision when you submit your request online. If more information or clinical documentation is needed, UnitedHealthcare will contact you.
Care providers can also call BeaconLBS at 800-377-8809 to start the notification/prior authorization process.
The notification/prior authorization requirement is for UnitedHealthcare Commercial benefit plan members. However, it doesn’t apply to care providers in Florida who are subject to the Laboratory Benefit Management Program.