United Healthcare Implementing New Compliance Requirements for the Laboratory Test Registration Protocol

August 14, 2020

On January 1, 2021 United Healthcare (UHC) will put into effect its Laboratory Test Registry Protocol. Laboratories will be required to submit the laboratory’s unique test code for each service performed. Each test code submitted on a claim must match a corresponding laboratory test registration provided in advance to UHC.  Failure to submit the lab test with the code will result in the claim being denied. The new requirements will apply to most United Healthcare Commercial, Medicare Advantage and United Healthcare Community Plan networks. To ensure compliance with the new requirements, UHC is asking for free standing and outpatient hospital laboratory providers to register their laboratory tests prior to December 1, 2020. 

United Healthcare has stated that simply registering your laboratory services and placing test codes on laboratory claims doesn’t guarantee UHC will pay the claim. Payment for the covered services is based on the member’s eligibility on the date of the service, claim processing requirements and the terms of your Participation Agreement.

Included is a link to the UHC notification and their frequently asked questions.