CLINICAL LABORATORIES AND ANATOMIC PATHOLOGY GROUPS working to register their tests with UnitedHealthcare’s (UHC) new Laboratory Test Registry Protocol just got a 90-day reprieve. UHC has delayed the start date to April 1, 2021.
“There is no truth to the rumor that UHC has ended the program before it began,” said Leigh Polk, Director of Sales and Marketing for Change Healthcare, a lab billing and consulting company. “The only change is that the program has a new start date of April 1.”
With more than 40-million beneficiaries, UnitedHealthcare is the nation’s largest health insurer. No other health insurance company has attempted to develop the scope and scale of UHC’s Laboratory Test Registry Protocol.
UHC is requiring all clinical laboratories and pathology groups to register every test and panel performed before March 1, 2021. Per the new update, effective April 1, UHC will not pay labs for claims if those tests or panels are not registered in UHC’s Lab Test Registry Protocol. (See TDRs, Aug. 3 and Oct. 5, 2020.)
Some Labs Not Prepared
The new implementation date is the third one that UHC has set since announcing the program. Previously, the deadline to register tests was Sept. 1 for payment that would begin Oct. 1, 2020. The second date to register tests was Dec. 1 for payment that would start on Jan. 1, 2021.
“Not all clinical labs or pathology groups are prepared for UnitedHealthcare’s new protocol,” noted Polk. “Even some billing companies are not prepared. But we are fully prepared. We continue to talk to our clients to help each lab get its test compendium uploaded to the UHC site.
Avoiding Denials After April 1
“At the same time, UnitedHealthcare is still working out a few items on its end. The instructions from UHC do not say certain fields are required, for example,” commented Polk. “So, when a clinical laboratory submits its test to the compendium during this registration period, that test claim will get denied if those fields are not completed correctly.”
Also, the instructions from UnitedHealthcare say that the unit of measure (UofM) for what is called Procedure Code 1 are misleading, Polk explained.
“While this is a required field, and UHC provides a list of applicable UofM codes in the appendix, if none are applicable to the test it can select ‘None.’ Doing so will not affect payment by UnitedHealthcare,” she noted.
For reflex testing, UHC said information is required on whether reflex testing is done, and the field needs to be marked as yes or no. “Again, this information is for UHC’s purposes only and will not affect payment,” she added.
Polk sent a notice to Change Healthcare clients alerting them to the new deadline, called the Test Compendium Upload Date.
“UnitedHealthcare is encouraging all clinical laboratories and pathology groups not to wait, but to submit their lab-test data as soon as possible,” she noted.
Contact Leigh Polk at 843-601-0184 or Leigh.Polk@ChangeHealthcare.com.