DateBilling Notice
📌 IMPORTANTOverutilization and Denial Notice – Aculabs
📌 IMPORTANTCauses for Exceeding LCD Maximum – Aculabs
📌 IMPORTANTImportance of Advanced Beneficiary Notices – Aculabs
10/09/2020October 2020 Price Announcement for New Test Profile
09/18/2020September 2020 Price Changes to the Current Aculabs Fee Schedule
05/21/2020May 2020 Price Changes to the Current Aculabs Fee Schedule
11/07/2019HICN Claims Reject for Medicare Starting 1/1/2020
04/25/2019Provider Notice Re: Aetna & Aetna Better Health

Insurance Information

  • AmeriHealth New Jersey
    • As of May 1, 2018, AmeriHealth New Jersey grants exlucivsity of provider status for all outpatient laboratory services to LabCorp.
  • Cigna
    • We are currently an out-of-network provider for Cigna health plans.
  • Horizon BCBSNJ
    • As of July 1st, 2019, Aculabs will be out-of-network for the following Horizon BCBSNJ plans: NJ DIRECT, Direct Access, Blue EPO & HMO, and OMNIA EPO. The only plans that Aculabs will still be reimbursed for are PPO and POS plans. Preauthorization numbers cannot be used, which means any claims will be denied. Any beneficiaries under these plans will have to go to LabCorp or Quest Diagnostics for servicing. It is the responsibility of all client facilities to know which patients are on such plans that Aculabs cannot be reimbursed under. If a lab slip is in a facility’s lab book for a patient with one of the previously listed plans, financial responsibility will be turned around onto the patient or facility.
  • Humana
    • We are currently an out-of-network provider for Humana HMO plans.
  • InnovAge
    • We are currently an out-of-network provider for InnovAge health plans.

Medicaid Information

While we are a contracted provider with Horizon NJ Health, some tests fall into the category of non-coverage.

Please be aware:

  • For DAS, Medicaid patients will not be billed and the bill for ordering the test will instead fall on the facility.
  • For Keppra testing, patients under Keystone 65, Personal Choice, Keystone, and Independence plans part of IBC will not be billed and the bill for ordering the test will instead fall on the facility.

Aculabs is actively working on becoming a provider for the following Managed Medicaid payors.  For the time being, all services performed on patients with the following insurance will be denied and the facility will be held liable:

  • Aetna Better Health of New Jersey
  • Aetna Better Health of Pennsylvania

Aculabs is currently a non-participating provider for the following plans:

  • Keystone First Community HealthChoices

Regarding residents with the following insurance, a preauthorization number must now be obtained before services can be processed:

  • Health Partner Plans, Managed Medicaid
  • PA Health & Wellness (We are now a provider effective 11/2019)

We appreciate your understanding and compliance at this time.