Refer your patients to a Designated Diagnostic Provider (DDP) for lab services
Last modified: July 13, 2021
Help members avoid unnecessary cost for lab services
Health care can be confusing and expensive. One area where we are working to help patients achieve lower costs is diagnostic services, like lab. We have updated benefits for many patients to include a tiered offering where they can save on their out of pocket costs. Our Designated Diagnostic Provider benefit lowers members costs when they are referred to and use a Designated Diagnostic Provider lab. Referring your patients to a Designated Diagnostic Provider lab will ensure that the services will be paid at a higher tier/ lower cost for each patient.
The following examples highlight why we are seeking your assistance in helping members get referred to Designated Diagnostic Provider labs:
When patients get care from a lab that is not a Designated Diagnostic Provider, they may end up paying as much as 1,000% more:
A comprehensive metabolic panel can cost $156 and at a Designated Diagnostic Provider location this costs could be $10. On average, for members that require monitoring on a quarterly basis, the annual cost difference is $580.
A blood glucose test can cost $80 and could cost $5 in a Designated Diagnostic Provider location. For members that require monthly testing, the annual cost difference is $900.
A rapid strep test can cost $56 and could cost $8 in a Designated Diagnostic Provider location. For a family with 2 symptomatic children that require testing, the cost difference is $96.
How to refer your patients to a Designated Diagnostic Provider for lab services
We know that it can be difficult to stay informed on changes to member benefits. By using Point of Care Assist directly in your electronic medical records (EMR) workflow, you’ll be able to instantly see Designated Diagnostic Providers and other laboratory care providers in your patient’s network and labs covered by their benefits, a patient’s benefit plan and estimated out-of-pocket costs.
With this information in your EMR workflow, you can help patients make informed health care decisions and connect them to cost-effective and quality providers. You will have real-time availability to your patient’s health plan information and available locations of care services for the best coverage.
For more information, visit UHCprovider.com/POCA. You can also contact your dedicated network representative with questions.