New Clinical Laboratory Improvement Amendments (CLIA) Identification Requirements Policy

In alignment with CMS and CLIA requirements effective Nov. 1, 2016 for participating providers and Aug. 1, 2016 for non-participating providers,  UnitedHealthcare will implement a new reimbursement policy that will be applicable to all laboratory services submitted on either a CMS 1500 claim form or HIPAA 5010 837 P claim file. The new reimbursement policy will apply to UnitedHealthcare Commercial and Medicare Advantage members. The policy requires that all claims for laboratory services include the CLIA number for the servicing care provider. The laboratory servicing provider’s physical address also will be required if the address differs from the billing provider’s address noted on the claim. The billing or servicing provider address must match the address associated with the CLIA ID number.

Source: https://www.unitedhealthcareonline.com/ccmcontent/ProviderII/UHC/en-US/Assets/ProviderStaticFiles/ProviderStaticFilesPdf/News/August-Network-Bulletin-PCA-1-002491_2016.pdf